Objective To evaluate the value of the muhifunctional angle regulator with shields in skeletal fluorosis X-ray radiography.Methods Conventional radiography,regulator with shields and regulator for radiography were used to examine the forearms and shanks of 78 patients,and then the quality of the photos and the diagnostic results were compared.The dose rates on patients' foresides,sides,and bottoms of division 1 and 2 m were measured by pressure ionization instrument.Results Regulator with shields and regulator for radiography had a higher rate of good quality than conventional radiography by 39 %,and consequently the diagnostic accuracy rate were improved by 37%(X2 = 43.33,43.98 and 17.76,14.56,P < 0.01).By conventional radiography the average dose rates on forearms and shanks I and 2 m away from X-ray axis were 1198,934 and 1439,1175 μSv/h,respectively;while regulator with shields and single regulator were used,corresponding average dose rates were 80.6,39.4 and 95.6,59.5/JSv/h and 375.7,187 and 447,226.3 μSv/h,respectively.Conclusions Angle regulator with shields is effective devices to examine the forearms and shanks of the patients who are suffering from dysfunction of skeletal fluorosis.

BACKGROUND: The quantity and bioactivity of isolated islet are vital to islet transplantation; while, the cold ischemia time and human leucocyte antigen (HLA) typing are key factors to islet quantity and bioactivity which inflect islet transplantation.OBJECTIVE: To observe the effects of cold ischemia time and blood compatibility on quantity and bioactivity of islet cells.DESIGN: Observational study.SETTING: Ruikang Affiliated Hospital of Guangxi College of Traditional Chinese Medicine.MATERIALS: Organs from voluntary donors died of irreversible coma were adopted whose blood-type and HLA typing had been known, pancreases acquisition was carried on after other organs ablation or in the meantime. The blood of identical ABO and HLA matching conformity, or HLA cross-matching hypersensitization (missmatching over 3 Iocuses),or panel reaction antibody (PRA) ＞ 50%, or lymphocyte cytotoxin crossmatching test positive. The isolated and purified islet suspension was filtered by 70 μm filter, which result in preparing 1.2×105/L islet suspention.METHODS: Hypertonic citrate adenine solution was perfused into aorta, and kidney-pancreases and kidney-pancreases-liver were cut together or kidney-pancreases-liver was cut separately. Islet activity was judged by diphenylthiocarbazone (DTZ) dyeing and acridine orange (AO) dyeing; meanwhile, twelve pancreases far from contamination were aquired, mean ablation time was 15 minutes; cold ischemia time ranged from 2.5 to 8 hours. Cold ischemia time of nine pancreases was controlled in 5 hours, warm ischemia time was 0-3 minutes, and peptic time was (15±2.4) minutes, correlation of islet cells and histocompatibility with survival of islet cells was analyzed.MAIN OUTCOME MEASURES: Survival rate of islet cells; counts of platelet, heterophil granulocyte and monocyte.RESULTS: The cutting of kidney, pancreases and liver were successful. If the cold ischemia time was controlled within 5 hours, activity of islets was above 80%. Pancreatic gland used for islet transplantation and cutting of other organs could not affect activity of islet cells. When human islets were exposed to human blood, it would induce a rapid consumption of platelets, neutrophils, monocytes and lymphocytes in the blood. Consumption of blood cells was more in the HLA typing groups than that in the control group. After adding heparin, there was significant difference in cell account among the three groups (P ＜ 0.05) and the reaction was relieved obviously. After 24-hour cultivation, there were significant difference in active islets quantity between HLA typing compatibility group and HLA typing incompatibility group (P ＜ 0.05).CONCLUSION: Pancreatic gland obtained under the cold ischemia time ＜ 5 hours can be used in clinical transplantation of islet cells; a good histocompatibility can raise successful rate of transplantation of islet cells.

BACKGROUND:It has great significance to understand individual human leucocyte antigen allele(HLA) haplotype and genotype in organ allotransplantation.OBJECTIVE:To analyse HLA allele frequency,haplotype frequency and characteristices in 36 cases of living-related donor kidney transplantation.DESIGN,TIME AND SETTING:The gene polymorphism analysis was performed in the Tissue Typing Laboratory of Organ Transplantation of Ruikang Hospital of Guangxi Traditional Chinese Medical University from January 2007 to June 2008.PARTICIPANTS:Thirty-six cases of living-related donor kidney transplantation,who were relatives of Guangxi Han population.METHODS:HLA-Ⅰantigen was detected by dry plates of monoclonal antibodies,and HLA-Ⅱ antigen was subjected to genotyping using PCR-SSP technique.And then the allele and haplotype frequencies of HLA-A,B,DRB1 were calculated.MAIN OUTCOME MEASURES:HLA haplotype and genotype of Guangxi Han population.RESULTS:A total of 11 HLA-A,24 HLA-B and 13 HLA-DR alleles were detected among 36 cases,showing a rich polymorphism.A2-B46,A11-B60,B46-DRB1*09,B60-DRB1*15 and A2-B46-DRB1*09 among 144 haplotypes were informative with frequency higher than 0.05.A total of 10 HLA-A-B haplotypes and 9 HLA-B-DRB1 haplotypes were in strongest linkage disequilibrium.Distribution of HLA-A,B,DRB1 alleles and haplotypes in Guanxi population is similar to Han population in South China,such as Hunan and Taiwan,but had its own characteristics.CONCLUSION:HLA alleles have richer polymorphisms with exhibit geographic genetic characteristics.

Objective To analyze the application of modified abdomen pathway for excising the adrenal huge pheoehromocytoma.Methods One patient(male,42-year-old)had adrenal huge pheochromocytoma.The pheochromocytoma was about 15.0 cm×8.0 cm×7.0 cm.After 3 weeks' preparations,the patient was operated.The operation was made through the modified abdomen pathway for excision,without excising the transverse on peritoneal,and the interference to organs of peritoneal was reduced.The tumor on adrenal gland adhered kidney very tightly.Expanded radical excision including tumor,kidney,adrenal gland was applied.Results The operative time was 300 rain and the volume of bleeding was about 1000 ml.In the operation process,blood pressure of the patient was stable,the visual field of operation was satisfactory.Blood pressure of the patient returned normal 6 months postoperatively.And there was no indication of tumour relapse or matastasis.Conclusion The modified abdomen pathway can expose the satisfactory visual field,and is safe and effective for adrenal gland tumor operation.

Objective:To study the risk factors for ipsilateral severe hearing impairment in patients with hemifacial spasm (HFS) after microvascular decompression (MVD).Methods:MVD was performed in 3700 patients with HFS, admitted to our hospital from October 2007 to August 2020; according to the existence of ipsilateral severe hearing impairment, these patients were divided into severe hearing impairment group and non-severe hearing impairment group. The clinical data of these patients were compared. Multivariate linear regression analysis was used to determine the independent influencing factors for ipsilateral severe hearing impairment.Results:Forty-five patients (1.2%) had ipsilateral severe hearing impairment after MVD; no one got recovery of hearing impairment during the follow-up period (0.6-11.8 years, 6.3 years in average). As compared with those in the non-severe hearing impairment group, patients in the severe hearing impairment group had significantly older age, significantly higher percentages of male patients, and patients with left HFS, hypertension, and diabetes mellitus, statistically higher percentage of patients having small posterior fossa volume, arachnoid thickening and adhesion, and vertebral artery compression, significantly lower percentage of patients with anterior inferior cerebellar artery compression, significantly higher percentage of patients with arteriosclerosis of offending arteries and difficult decompression ( P<0.05). Multivariate linear regression analysis revealed that hypertension, vertebral artery compression, arteriosclerosis of offending artery and difficult decompression were independent risk factors for severe hearing impairment in patients with HFS after MVD. Conclusion:It's difficult to get recovery for severe hearing impairment in patients with HFS after MVD; this complication is much common in patients with hypertension, vertebral artery compression, arteriosclerosis of offending artery or difficult decompression.

Objective:To evaluate the effect of standardized bowel preparation and nursing procedures in patients with colon disease underwent full abdominal CT examination.Methods:A total of 281 inpatients who were diagnosed as "colon tumors" and underwent full-abdominal CT examinations from January 2016 to December 2017 were selected. From January to December 2016, 153 patients were included in the study, which is the pre-implementation group; from January to December 2017, 128 patients were included in the study, all of whom received standardized bowel preparation and nursing procedures, and were the post-implementation group. Compare and observe the differences in the cleanliness, intestinal filling and CT image quality of patients before and after the intervention measures.Results:After the implementation of standardized nursing procedures, the proportion of patients with good intestinal cleanliness was 71.09% (91/128), which was higher than the pre-implementation of 33.33% (51/153) ( χ2 value was 40.79, P<0.001). The proportion of patients with sub-intestinal preparations also decreased ( P<0.05). The proportion of patients with good intestinal filling in the post-implementation group was 75.00% (96/128), which was higher than 42.48% (65/153) in the pre-implementation group ( χ2 value was 42.63, P<0.001). After the implementation of standardized nursing procedures, the image quality rate of patients with whole abdominal CT was 90.63% (116/128), which was higher than the pre-implementation 32.68% (50/153) ( χ2 value was 98.34, P<0.001). Conclusion:The standardized nursing process can improve the quality of bowel preparation and significantly improve the image quality of abdominal CT examination.