Objective To improve the clinical prognosis of patients by reviewing ten years epidemiology data of acute poisoning inpatients.Methods The epidemiology data of the acute poisoning inpatients from 2006-2015 were retrospectively analyzed.The indexes including age,gender,nationality,geographical distribution,substance of poison,seasons,diagnosis and fee-for-service were collected.Results There were 1 083 patients with acute poisoning in total,624 cases (57.6％) for gas poisoning,213 cases (19.7％) for pesticide poisoning,136 cases (12.6％) for drug poisoning,74 cases (6.8％) for food poisoning and 36 cases for others.The ration of male to female was 0.94:1.The age of 31 to 45 range accounted for the highest proportion.The incidence of poisoning in 2011-2015 was significantly higher than that in 2006-2010 (P ＜0.05).The geographical distribution was also significantly different (P ＜0.05),most of the cases were in Shihezi city,then were Manasi and Sawan counties.Among the 1 083 patients,59％ cases were cured,33.6％ cases were improved after treatment,and the mortality rate was 2.6％.Feefor-service was also significantly increased in the older patients or males,and substance of poisoning dependent.The highest treatment cost was carbon monoxide poisoning,then were pesticide,drugs and food.Conclusions The common causes of poisoning in Shihezi city were carbon monoxide,organophosphorus pesticide,botulism and drugs,more emergency medical service should prevent poisoning and treat these patients.

Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.

Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.

Objective To explore the feasibility of combining anterior and posterior fontanelle acoustic windows for fetal median sagittal plane cranial scanning in prenatal ultrasound.Methods From July 5 to August 25 in 2012,200 pregnant women in Huai'an First Hospital at 22 to 24 gestational weeks accepted transabdominal uhrasonography,with anterior fontanelle,longitudinal suture and posterior fontanelle as acoustic windows to obtain the median sagittal plane.In the mean time,ten aborted or induced fetuses (with malformations or maternal complications) underwent cranial ultrasound with the same acoustic windows.The successful rates of obtaining median sagittal plane were calculated.Data were analyzed by Chi-square test.Results (1) Among the ten aborted or induced fetuses,all median sagittal planes were successfully obtained through anterior,posterior fontanelle,or longitudinal suture alone.(2) Among the 200 cases of prenatal uhrasonography,the successful rate of obtaining median sagittal plane through posterior fontanelle alone was 76.0％(152/200),which was higher than that through anterior fontanelle alone [59.5％ (119/200),x2=12.5,P＜0.01].The successful rate was 95.5％ (191/200) when combining the anterior and posterior fontanelle,which was higher than that through anterior fontanelle or posterior fontanelle alone (x2 =74.3 and 31.1,both P＜0.01).The successful rate of obtaining median sagittal plane through posterior fontanelle was 67.3％ (65/102) in cephalic presentation,which was also higher than that through anterior fontanelle [37.3％ (38/102),x2 =14.3,P＜0.01].The successful rate was 88.8％ (87/98) through posterior fontanelle in non-cephalic presentation,which was similar to that through anterior fontanelle [82.7％(81/98),x2 =1.5,P＞0.05].When both anterior and posterior fontanelle applied,the successful rate in cephalic presentation was 9.8％ (10/102),lower than that in non-cephalic presentation fetuses [71.4％ (70/98),x2 =79.1,P＜0.01].Conclusions The successful rate in obtaining median sagittal plane through posterior fontanelle is higher than that through anterior fontanelle,and might be increased when both anterior and posterior fontanelle were used.

Objective Konno-Rastan procedure is one option to cope with complex multilevel left ventricular outflow tract obstruction (LVOTO),which continues to pose a serious challenge to cardiac surgeons.The aim of this study is to retrospectively analyse indications for Konno-Rastan procedure,and to review the safeguards and pitfalls.Methods Between January 1996 and August 2012,totally 13 children with multilevel LVOTO underwent Konno-Rastan procedure.There were 8 boys and 5 girls.Age at surgeries ranged from 5 to 13 years,and weight from 12 to 51 kg with median of 21 kg.The pathology of this cohort includes:8 cases of congenital aortic valvular stenosis,3 cases of congenital aortic valvular stenosis combined with supravalvular stenosis,1 case of congenital aortic stenosis combined with VSD,coarctation and RVOT obstruction,1 case of aortic stenosis s/p percutaneous balloon aortic valvuloplasty.All patients have secondary diffuse tunnel LVOTO.Diameter of aortic ring ranges from 12.0 to 16.4 mm,and pressure gradient across the stenotic region ranges from 90-151 mm Hg.8 cases were implanted with St.Jude AG19 while 5 cases implanted with St.Jude AG17.Results All 13 cases survived.The 4th patient was implanted permanent epicardial pacemaker for transient Ⅲ AVB.The 4th and 5th patients were found residual ventricular septal repture at the nadir of ventricular incision,one underwent redo procedure while another is being followed up.All cases take cumadine to sustain INR at 1.8-2.5.No death emerges during follow-up period.The motality is 0％,the incidence rate of B is 7.7％,residual VSD 15.4％ and endocarditis 7.7％.Conclusion Konno-Rastan procedure is a promising techi.to relieve LVOTO.However,this complex procedure may lead to several fetal complications.Success of the surgery demands perfect operations.

Objective To explore the effects of dehydroepiandrosterone (DHEA) on learning and memory ability and activities of choline acetyltransferase (ChAT),acetylcholinesterase (AchE),acetylcholine (Ach) in the frontal,temporal,hippocampal area of the aged rat.Methods Forty 24-month-old male SD rats were randomly divided into 4 groups (n=10,each group):control group,solvent group (intraperitoneal injection with equal volumes of DMSO),low-dose group (intraperitoneal injection with equal volumes of DHEA,1 mg/kg),and high-dose group (intraperitoneal injection with equal volumes of DHEA,5 mg/kg).The activities of ChAT,AchE,and Ach were measured by enzyme linked immunosorbent assay (ELISA) method.Learning and memory ability was detected by Morris water maze test.Results The levels of ChAT in frontal,temporal and hippocampal area were (118.5±1.3) U/mg,(120.6±1.5) U/mg,(130.8±1.5) U/mg,respectively in control group,(i39.5±1.6) U/mg,(137.4±1.4) U/mg,(141.46±1.9) U/mg,respectively in high-dose group,(131.8±1.9) U/mg,(132.4±1.2) U/mg,(139.9±1.3) U/mg,respectively in low-dose group.The levels of AchE in frontal,temporal and hippocampal area were (0.5±0.0) U/mg,(0.4±0.0) U/mg,(0.5±0.0) U/mg,respectively in control group,(0.4±0.0) U/mg,(0.4±0.0) U/mg,(0.4±0.0) U/mg,respectively in high-dose group,and (0.4±0.0) U/mg,(0.4±0.0) U/mg,(0.4±0.0) U/mg,respectively in low-dose group,and (0.5±0.0)U/mg.The Ach levels in frontal,temporal and hippocampal area were (26.0±0.8) U/mg,(24.5±1.4) U/mg,(30.1±0.8) U/mg respectively in control group,(28.7±0.9) U/mg,(28.9±1.3) U/mg,(35.9±1.4) U/mg,respectively in high-dose group,and (27.6±0.1) U/mg,(28.0±1.1) U/mg,(34.2± 1.0) U/mg,rcspectively in low dose group.The activities of ChAT in frontal,temporal and hippocampal area were higher in DHEA treatment group than in control group (P＜0.05).The activities of AchE in frontal,temporal and hippocampal area were much lower in DHEA treatment group than in control group (P＜ 0.05).The Ach levels in frontal,temporal and hippocampal area were much higher in DHEA treatment group than in control group (P＜0.05).There were significant differences in the activities of ChAT and AchE and Ach levels between low-dose group and high-dose group (P＜0.05).Compared with control group,the activities of ChAT and AchE and Ach levels had no significant differences in solvent group (P＞0.05).The escape latency was shorter in low-dose group and high-dose group than in control group (P＜0.05,P＜0.01,respectively),and there was a significant difference in escape latency between low-dose group and high dose group (P＜ 0.05).Conclusions DHEA administration can significantly increase the activity of cholinergic system,and improve the learning and memory ability in aged SD rats.

Objective The study aimed to explore the development direction of congenital heart disease surgery through comparing Europe with Guangdong General Hospital(GDGH) in data of ECHSA Congenital Database.Methods The data between 2009 to 2015 of Europe and GDGH were extracted from ECHSA Congenital Database.The data of Europe and GDGH were compared by basic information,operating difficulty and mortality.Results The results of Europe and GDGH were patient number(71 763 vs 13 119),procedure/patient ratio(126.2％ vs 104.1％),age[(75.91 ± 146.18) months VS(105.80 ± 172.18) months],the proportion of neonate (18.2％ vs 4.4％),Aristotle mean score (7.00 vs 6.67),30 days mortality (2.98％ vs 1.73 ％).The proportion of neonate palliative operation of Europe was more than that of GDGH.In adult group,Europe was more of reoperation and of GDGH was more of primary surgery.Conclusion The surgical treatment of congenital heart disease of GDGH is developing and is close to the mean average of Europe.The proportion of neonate,complex surgery and reoperation is lower than Europe.

Objective:To explore the environmental risk factors of different categories of congenital heart defects ( CHD) and provide evidence for further risk factors and prevention research of CHD pheno-types. Methods:Data of Guangdong CHD Register Study from 2004 to 2012 were used. In the study, 3 038 CHD cases and 3 038 paired controls from 34 hospitals distributed in 17 cities were registered and related information were collected using uniform, and structured questionnaires. All the CHD phenotypes were coded according to the International Classification of Diseases 10th Revision (ICD-10) and classified into 6 categories according to their pathological features. Univariate analyses were adopted to filter poten-tial risk factors for each category of CHD. Then multivariate conditional Logistic regression was used to calculate the odds ratios of the risk factors for each category of CHD. Results:The risk factors for left-to-right shunt CHD included low ( OR=2 . 63 , 95%CI:2 . 04 -3 . 39 ) or over birth weight ( OR =2 . 21 , 95%CI:1 . 47-3 . 32 ) , premature delivery ( OR=1 . 95 , 95%CI:1 . 53-2 . 49 ) , polyembryony ( OR=1. 99, 95%CI: 1. 22 -3. 26), maternal low education, mother as factory worker (OR =1. 62, 95%CI:1 . 32-1 . 98 ) , parity≥2 ( OR =1 . 38 , 95%CI: 1 . 13 -1 . 69 ) , maternal abnormal reproduction history ( OR=2 . 29 , 95%CI:1 . 75-3 . 01 ) , fever ( OR=2 . 38 , 95%CI:1 . 26-4 . 48 ) , virus infection ( OR=1 . 80 , 95%CI:1 . 29 -2 . 51 ) , medicine usage ( OR=1 . 73 , 95%CI:1 . 11 -2 . 69 ) , passive smoking ( OR=1 . 69 , 95%CI:1 . 26-2 . 29 ) , chemical agent contact ( OR=8 . 71 , 95%CI:2 . 33 -32 . 58 ) , living in newly decorated houses ( OR=2 . 56 , 95%CI:1 . 60-4 . 09 ) or room close to the main road ( OR=1 . 40 , 95%CI:1 . 14-1 . 72 ) in the first 3 months of pregnancy and father as factory worker ( OR=1 . 46 , 95%CI:1 . 23-1 . 73 ) . The risk factors for pulmonary outflow tract obstruction CHD in-cluded low ( OR =5 . 98 , 95% CI: 2 . 88 -12 . 44 ) or over birth weight ( OR = 6 . 56 , 95% CI:1. 19-36. 26), maternal low education, parity≥2 (OR=2. 08, 95%CI:1. 03-4. 22), virus infection in the first 3 months of pregnancy ( OR =4 . 30 , 95%CI: 1 . 27 -13 . 45 ) . The risk factors for left ventricular outflow tract obstruction CHD included father as factory worker ( OR=6 . 01 , 95%CI:1 . 05-34. 59). The risk factors for transposition of the great arteries included low birth weight (OR=12. 93, 95%CI:1. 14-146. 26), maternal low education, mother as factory worker (OR=3. 69, 95%CI:1. 53-8. 91). The risk factors for conditions with intra cardiac mixing of oxygenated and deoxygenated blood in-cluded parity=2 ( OR=3 . 45 , 95%CI:1 . 42-8 . 38 ) . The risk factors for other CHD included over birth weight (OR=4. 87, 95%CI:1. 19-19. 94), maternal abnormal reproduction history (OR=2. 96, 95%CI:1. 14 - 7. 68 ), virus infection ( OR = 4. 92, 95% CI: 1. 56 - 15. 47 ), medicine usage (OR=4. 90, 95%CI:1. 22-19. 77) or passive smoking (OR=10. 31, 95%CI:1. 25-85. 05) in the first 3 months of pregnancy. Conclusion:The environmental risk factors were discrepant among different categories of CHD. Further risk factors study of CHD phenotypes should be performed specially. To prevent CHD, attention should be paid to the risk factors which are related to multi or complex categories of CHD.

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OBJECTIVETo investigate the risk factors for post-stroke pneumonia and assess the value of A(2)DS(2) score in predicting post-stroke pneumonia in elderly stroke patients.

METHODSThe clinical data were retrospectively collected from elderly stroke patients from January, 2007 to December, 2012. A(2)DS(2) score was then assigned using the clinical information from the medical record. The ability of the score to discriminate between patients with post-stroke pneumonia and those without was quantified using ROC analysis. The calibration of the score was analyzed using Hosmer-Lemeshow goodness-of-fit test.

RESULTSA total of 131 elderly male stroke patients were enrolled in this study, among whom the incidence of post-stroke pneumonia was 29.01%. The independent risk factors for post-stroke pneumonia identified included moderate (P=0.0081, OR: 5.6089; 95%CI: 1.5663-20.0854) and severe (P=0.0048, OR: 44.4827; 95%CI: 3.1847-621.3126) neurological impairment, dysphagia (P=0.0005, OR: 7.5265; 95%CI: 2.4282-23.3292), and atrial fibrillation (P=0.0226, OR: 4.1778; 95%CI: 1.2221-14.2825). The incidence of post-stroke pneumonia ranged from 2.2% in patients with a A(2)DS(2) score less than 3 to 75% in those with a score higher than 8. The C-statistic of A(2)DS(2) score for predicting post-stroke pneumonia was 0.86 (95%CI: 0.784-0.911) by the ROC analysis. The A(2)DS(2) score was well calibrated to predict post-stroke pneumonia in elderly patients by Hosmer-Lemeshow test (7.083, P=0.528).

CONCLUSIONThe A(2)DS(2) score can be useful for predicting post-stroke pneumonia and for routine monitoring of high-risk elderly stroke patients in the clinical setting.

Aged ; Aged, 80 and over ; Atrial Fibrillation ; complications ; China ; Deglutition Disorders ; complications ; Humans ; Incidence ; Male ; Pneumonia ; epidemiology ; etiology ; prevention & control ; ROC Curve ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stroke ; complications