Objective To evaluate the accuracy of ultrasonographic measurement of the transverse diameter of the cricoid cartilage in selecting the cuffed endotracheal tube (ETT) size for pediatric patients.Methods A total of 120 pediatric patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 1 month-6 yr,with body mass index of 10.9-31.2 kg/m2,undergoing endotracheal intubation and general anesthesia,were divided into group A and group B,with 60 pediatric patients in each group.The pediatric patients were intubated with a cuffed ETT in two groups.The ETT size was selected based on the transverse diameter of the cricoid cartilage measured by ultrasonography in group A.The ETT size was selected according to the age-based formula in group B.A tracheal leak was detected after intubation to determine whether or not the ETT size selected was appropriate.ETTs were replaced when the actually selected ones were not appropriate,and the number of replacement was recorded.The development of intubation-related complications was also recorded.Results The accurate rate of cuffed ETT size selected at the first time was 95％ in group A,and it was significantly higher than that in group B (60％) (P＜ 0.05).There was no significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Uhrasonographic measurement of the transverse diameter of the cricoid cartilage produces higher accuracy in selecting the cuffed ETT size for pediatric patients and is worthy of clinical application.

Objective To investigate the quality of autoantibody testing around the whole country.Methods Laboratories that perform autoantibody testing were recruited by letters or telephone communications.The auto-antibodies examined by the quality-control survey included anti-nuclear antibody (ANA),anti-double-stranded DNA (anti-dsDNA) antibody,anti-extractable nuclear antigens (anti-ENA),antimitochondria antibody (AMA),anti-smooth muscle antibody (ASMA),and anti-citrulline antibody (CCP).Each autoantibody was tested for 3 samples,so 15 samples were tested in total.Sample distribution and data analysis were double-blinded.Qualitative interpretation,staining patterns were evaluated by IIF.The agreement with qualitative interpretation for each specimen was evaluated by ELISA,and Immuno-Blot/Dot-Blot.Results One hundred and eight laboratories participated in this study.The testing methods included indirect immumofluorescence (IIF),immuno-Blot (IB),Dot-Blot (DB),double diffusion method (DID),enzymelinked immunosorbent assay (ELISA),chemo-illuminescent assay,Dot-immunogold filtration assay.The accuracy rates were 82％,83％,95％,96％,86％,respectively for ANA,anti-dsDNA,AMA,ASMA,and anti-CCP antibody.Anti-ENA were further divided into anti-SNP,anti-Sm,anti-SSA,anti-SSB,anti-Scl-70 subgroups,and the accuracy rates were 84％,95％,98％,98％,88％,respectively.The distribution of quantitative values by different laboratories for ANA (by IIF),anti-dsDNA,anti-CCP antibody (by ELISA) varied remarkably.Conclusion Hospitals that enrolled in the survey and the items involved for quality control were increasing year by year.The accurate rates of ANA,anti-dsDNA in this survey were similar to the past national quality control surveys,the quality of AMA/ASMA,anti-CCP antibodies test was better than that of the past surveys,but the quality of anti-ENA antibodies test needs to be improved.

Objective To manage the information of examination, certification and registration of doctors in the organizations of medical treatment, prevention and health care. Methods A software was developed by using the client/server model and object-oriented technique on the basis of experiences from many years of hard working in military hospital. Results Because of the successful design and application of the software, the whole military certificated doctors information database was established for trends tracking management of all military certificated doctors' information by general departments. Conclusion The database management and developing technique are the same as those of No.1 Military Medical System. It is very practical.

Objective To research the functions and design methods of data center for regional collaborative healthcare.Methods Combined with the informatization of regional collaborative healthcare,the necessary for constructing the regional medical data center was analyzed,with its task and implementation discussed.Results A set of solution to data storage,service and coding in the data center for regional collaborative healthcare was put forward.Conclusion The data center promotes the informatization of regional collaborative healthcare.

OBJECTIVETo compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis.

METHODSFrom January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening.

CONCLUSIONThe early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.

Aged ; Arthritis, Rheumatoid ; physiopathology ; surgery ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Deformities, Acquired ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Retrospective Studies

The specification of decoction pieces and quality uniformity are the important factors to influence the efficacy of clinical medicine. Considering the deficiency of diversity, poor quality uniformity and confusion of decoction pieces specifications, we first propose a new idea of precision decoction pieces (PDP) based on clinical demands and fresh-processed technology. In order to explain the idea, a study case of aconite SUP is provided, including the optimized specification design, processing technology, extraction effects, quality uniformity, and toxic and efficacy variation and so on. The results showed that preparing 5 mm PDP by fresh-cutting is rather simple and practicable, with high efficiency and large yield; then, this technology could significantly decrease the ingredients loss and increase the efficacy components; moreover, it was helpful for achieving the quality uniformity and best extraction effects. This work revealed the quality superiority of PDP, and provided a good strategy and example for the standard of decoction pieces specification and modernization of processing technology.
Aconitum ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Particle Size ; Plant Extracts ; chemistry ; pharmacology ; Quality Control

Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the others (P < 0.05) followed by Hanzhong aconite, which is consistent with the traditional understanding of genuineness. It can be concluded that IQI achieves the integrated control and evaluation for the quality of Chinese medicinal materials, and it is an exploration for building the good medicinal herbs standards. In addition, IQI provides technical supports for the geoherbalism evaluation, selective breeding, the development of precision decoction pieces, high quality and favourable price in market circulation, and rational drug use.
Aconitum ; chemistry ; Drugs, Chinese Herbal ; standards ; Medicine, Chinese Traditional ; standards

Quality control is one of the key scientific tissues in the modernization of traditional Chinese medicines (TCM). In order to overcome the deficiencies of assessment indexes, including little systematization and quantification, as well as loose association with clinical efficacy and dosage, a new integrated method named controllability pyramid ( CP) is first proposed in this paper. In addition, some study cases are used to explain how this model is constructed. We hope the establishment of CP could promote the clinical-orien- ted integrated innovation research of TCM, and provide control strategy and technology examples for improving the quality of Chinese medicines and clinical efficacy.
China ; Drug Evaluation ; methods ; standards ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; standards ; Humans ; Medicine, Chinese Traditional ; standards ; Quality Control

Hereditary dentinogenesis imperfecta is a rare autosomal dominant hereditary disease. This article reported a case of hereditary opalescent dentin and discussed the clinical features and treatment.
Dentinogenesis Imperfecta ; Humans

AIM:To observe the pathological changes of the lower segment of nasolacrimal duct mucosa in rabbits at different stages after retrograde lachrymal dilated drainage tube implantation.
METHODS:Totally 14 New Zealand rabbits were used in the present study. One side of nasolacrimal duct was obstructed to produce an experimental model and operated the reverse implantation of nasolacrimal duct intubation. Histological changes of the lower segment of nasolacrimal duct mucosa were observed by routine light microscope at 2, 4, 6, 8, 10, 12 and 14wk after the operation.
RESULTS: Compared with the control side, the group of 2 and 4wk after surgery presented the inflammatory cytokine. The group of 12wk after the operation presented isolated granuloma. Group 12 and 14wk presented scattered granuloma. The size of the granulomas was smaller and the density of epithelioid cell and fibroblast were lower in group 12wk than those in group 14wk by HE and Masson trichrome stain.
CONCLUSION:Recurrent Silicone Tube is used to treat nasolacrymal duct obstruction. Nasolacrimal duct can be narrowed and blocked again by granuloma, progressive fibrosis and adhesion of surrounding tissues when tube is in the duct more than 12wk.