Adult ; Aged ; Electrocardiography ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Silicosis ; complications ; diagnostic imaging

From the practice of application of PBL teaching in biochemistry,we find that the PBL has obvious advantages in inability training,class course and knowledge application,but the PBL should be applied in limited theory-learning course.

To investigate the pathological changes in gunshot wound track in limbs of dogs produced under a hot and humid environment, 8 dogs were randomly divided into two groups: hot and humid environment group (HHE) and normal environment group(NE). Gross examination, optical microscopic examination (OM), electron microscopic examination (EM) were performed, and ATP, ADP, AMP content, energy charge (EC) in the gunshot wounds were observed at 4, 8, 12, 24h after wounding. The results indicated that 6～8 h after the injury, the wound tracks and discolored area of tissue in HHE group were more distinguished and enlarged than those in NE group, and the swelling of wounded limbs was obvious. Some of the wounds began to be odoriferous. The signs of infection began to be obvious. While the wounds of NE group did not give off obvious odor of decay until 12～24h after the injury. Under OM and EM, necrosis and damage of muscle fibers in the wound tracts were more obvious in the HHE group than that in NE group, showing a tendency of deterioration. In contrast the changes in the injured tissues in NE group showed a tendency of improving. ATP content of the injured tissues in the contusion region of HHE group was lower than that of NE group at 8h, ATP content of tissues in the shock region of HHE group was decreased continuously and was lower than that of NE group at 12h. ADP content of tissues in the contusion area of HHE group was lower than that of NE group at 8h and also in shock area at 12h. AMP content of tissues in the contusion area of HHE group was higher than that of NE group at 12h, whereas EC of tissues in the contusion area of HHE group was lower than that of NE group at 8h and 12h. Histopathological changes in tissues in the gunshot wound were serious and deteriorated gradually in hot and humid environment. At the same time the energy storage of muscle tissue in the gunshot wound track was lower and decreased more remarkably in this environment. Therefore early and complete debridement of gunshot wounds inflicted in hot and humid environment should be emphasized.

OBJECTIVETo explore the clinical effects of internal fixation with lag screws plus an anti-sliding plate for the treatment of Hoffa fractures of the lateral femoral condyle.

METHODSFrom May 2006 to May 2014, 17 patients with Hoffa fractures of the lateral femoral condyle were treated with lag screws plus an anti-sliding plate. There were 13 males and 4 females, ranging in age from 27 to 59 years, with a mean of 32.5 years. All the fractures were fresh and closed fractures. According to the Letenneur's classification, 8 cases were type I, 4 cases were type II, 5 cases were type III. All the patients had no injuries of the cruciate ligament and the another part of the knee. Operative incision and fracture healing time were observed, knee joint function was evaluated by Letenneur system and HSS standard.

RESULTSThe patients were followed up from 10 to 24 months with a mean of 14.6 months. All incisions achieved primary healing, and no internal fixation breakage, malunion, femoral candyle necrosis, deep vein thrombosis of lower extremity were found. Fracture healing time was from 4 to 9 months with an average of 4.7 months. According to Letenneur's functional assessment, 10 patients got an excellent results, 4 good, 3 fair. Total HSS score was 91.1 +/- 4.7 on average,15 cases obtained excellent results, 2 good.

CONCLUSIONInternal fixation with lag screws and an anti-sliding plate can result in excellent effects for Hoffa fractures of the lateral femoral condyle. The key to a successful surgery is an anatomic reduction and rigid fixation of the fracture.

Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; physiopathology ; surgery ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Closed ; physiopathology ; surgery ; Humans ; Ligaments, Articular ; surgery ; Male ; Middle Aged

Objective To investigate the implementation effects of control measures and the dynamic prevalence of drinking-water-borne endemic fluorosis,in order to provide a scientific basis for developing control measures against the disease.Methods According to the Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis,137 counties were selected as monitoring counties in national 27 provinces (autonomous regions,municipalities) and Xin Jiang Production and Construction Corps.Three epidemic villages were selected as fixed monitoring villages in each county.The operating condition and the fluoride level of water improvement projects were investigated in the villages with water improvement projects.The fluoride level of drinking water was tested in the villages without water improvement projects.The fluoride content in drinking water was detected by the Standard Test Method for Drinking Water (GB/T 5750.5-2006).The preyalence of dental fluorosis of all children aged 8-12 were surveyed,and dental fluorosis was diagnosed by Clinical Diagnostic Criteria of Dental Fluorosis (WS/T 208-2011).Results ①427 villages were surveyed in 2012,among which the villages with water improvement projects accounted for 75.88％ (324/427).② 299 water improvement projects were investigated.Normal operation rates of those were 89.30％ (267/299).The qualified rate of fluoride content was 75.78％ (219/289).Totally 103 villages without water improvement projects were monitored.Villages with fluoride level ＞ 1.2-2.0 mg/L,＞ 2.0-4.0 mg/L and ＞ 4.0 mg/L accounted for 48.54％ (50/103),29.13％ (30/103) and 9.71％ (10/103),respectively.(③The national detection rate of dental fluorosis and community fluorosis index (CFI) in children aged 8-12 were 31.24％ (8 677/27 773) and 0.66.The detection rate and CFI of the villages with normal operation projects and the qualified fluoride content were 24.04％ (3 999/16 634) and 0.51.The detection rate and CFI of the villages with water improvement projects under abnormal operation or excessive fluoride were 40.77％ (1 654/4 057) and 0.91.The rate and CFI of the villages without water improvement projects were 42.70％ (3 024/7 082) and 0.86.Conclusions The rate of water improvement projects of the whole country is lower.The national normal operation rate of water defluoridation improvement projects is below 90％,and the qualified rate of fluoride content in drinking water is below 80％.The prevalence of dental fluorosis in children aged 8-12 is very mild.

Objective: To evaluate the surgical procedures and prognostic factors for colorectal carcinoma in patients aged over 70. Methods: We retrospectively reviewed 31 colorectal cancer patients aged over 70 seen in our hospital between January 1992 and December 2001.Treatment procedures and outcome of these patients were analyzed.Kaplan-Meier method was used for survival analysis and Cox regression analysis was conducted to analyze prognostic factors. Results: The median age of these patients was 74 years.The median follow-up period was 12 months.The postoperative complication rate was 22.6%.The thirty-days mortality was 6.5%.There were 28 cases of tubular adenocarcinoma (well differentiated in 5 cases,moderately differentiated in 16 cases,and poorkly differentiated in 7 cases)and 3 cases of mucinous adenocarcinoma.As to Dukes stage,there were 8 cases of B stage,9 cases of C stge,and 14 cases of D stage.The overall 5-year survival rate was 22.7%.The 5-year survival rate was 44.4%in the radical surgery group and 7.7%in the palliative surgery group.The median survival period of all patients was 12 months.The median survival period was 38 months in the radical surgery group and 9 months in the palliative surgery group.Univariate analysis showed that the predictors for survival were age,co-morbidity,preoperative serum CEA level,preoperative serum albumin concentration,duration of surgery,radical surgery,and cancer stage. Conclusion: Radical resection is a prerequisite for cure of colorectal cancer with obstruction in elderly patients.Age and preoperative serum albumin concentration are independent prognostic indicators.

Objective To explore the role of CD3 +CD8 +T cells in children with severe bacterial meningitis at early stage by studying the changes of CD3 +CD8 +T cells and its relationships with markers of inflammation and humoral immunity. Methods Thirty-nine cases aged ≤14 years old were enrolled in this retrospective study,who were admitted in our PICU from Aug 1. 2014 to Dec 31. 2015 with diagnosis of se-vere bacterial meningitis. The patients were divided into 2 groups according to the changes of CD3 +CD8 + T cells:group A:normal or elevated(≥190/mm3,n=22),group B:decreased( <190/mm3,n=17). Distribu-tion and differences of biomarkers of inflammation,humoral immunity and changes in cerebrospinal fluid be-tween the two groups were analyzed. Results The ratio of CD3 + CD8 + T cells were decreased in 17 (43. 6%)cases. Though there was no statisticly significant difference,the percentile of patients in group B (58. 8%) with Glasgow coma score lower than 8 was higher than that in group A(31. 8%). All the four death were in group B. The mean values of C-reactive protein and procalcitonin were 251. 0(26. 2,417. 0) mg/L,32. 7(0. 9,100. 0) ng/L in group B,which were higher than those in group A[106. 5(12. 0,458. 0) mg/L,4. 5(0. 1,200. 0)ng/L],respectively(P<0. 05). Six cases(35. 3%) in group B with WBC<4 × 109/L was more than 1 case(4. 6%) in group A,and 12 cases(70. 6%) in group B with ratio of neutrophils>80% was more than 7 cases(31. 8%) in group A,there were significant differences(P<0. 05). Fourteen cases(82. 3%) with glucose concentration lower than 2. 0 mmol/L in group B was more than 11 cases (50. 0%) in group A,the difference was significant(P<0. 05). Conclusion CD3 +CD8 +T cells might be suppressed in children with severe bacterial meningitis at early stage,and might associate to the damaging de-gree of brain,inflammation reaction and prognosis in those patients,which should be helpful in using of im-mune regulators for children with severe bacterial meningitis.

Objective To investigate the expression and significance of death receptor 4(DR4) and DR5 in human craniopharyngioma.Methods The expression of DR4 and DR5 was determined by immunohistochemistry and in situ hybridization in 28 samples of craniopharyngioma and 25 samples of normal brain tissue.Results With low expression in partial normal brain tissue,DR was expressed highly in all of the craniopharyngioma samples.High DR expression in craniopharyngioma tissue differed from low DR expression in normal brain tissue(P0.05).Conclusions High DR expression is prevalent in craniopharyngioma tissue.This may contribute to the apoptosis-induced therapy of craniopharyngioma.The control of DR expression lays in protein level.This may contribute to the selective induced-apoptosis of tumor necrosis factor-related apoptosis-induced ligand.

Objective To study the expression level and clinical significance of bcl-XL gene in childhood medulloblastoma.Methods The expression of Bcl-XL protein and bcl-XL mRNA were determined by immunohistochemical staining and in situ hybridization in 41 samples of medulloblastoma tissues,as well as 20 normal brain tissues.Results The positive rate of Bcl-XL protein(90.2%) and bclXL mRNA(95.1%) in medulloblastoma group were significantly higher than those in normal human brain tissues(all P

Objective To analyze the clinical characteristics,treatment and prognosis of primary lymphoma of bone (PLB).Methods Retrospective analysis of 9 cases with newly diagnosed PLB was performed.The primary lesion was located in bone and no evidence of lesion was found in other tissues.All the lesions were confirmed by histological examination and immunohistochemical staining.The clinical manifestation and radiological appearance of all cases were non-specific.Results 9 patients were enrolled in the current study including 6 males and 3 females with average age of 34 years old (15-71 years old).All cases had suffered local pain or edema as initial symptom.Single bone infiltration was detected in 7 patients,while multiple bones infiltration was noticed in 2 patients.The lesion distribution was as follows:4 lesions were situated in pelvis (3 in ilium and 1 in sacral),1 in femur,1 in humerus,1 in scapula,and 2 in spine.2 cases were treated with radiotherapy and chemotherapy,3 cases were treated with chemotherapy and hematopoietic stem cell transplantation,1 case was treated with chemotherapy and surgery,and 3 cases received chemotherapy alone.With in a median follow-up of 8 months,6 patients showed overall response (including 5 cases of complete response and 1 case of partial response).Conclusions PLB is a rare condition,and the diagnostic criteria and treatment are still not well defined.Early diagnosis and prompt treatment usually achieves satisfactory prognosis.The possibility of PLB must be concerned for patients with bone pain,soft tissue swelling or unexplained fractures,and pathological examination should be carried on as soon as possible.