Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

The Offsite Medical Accounting Information Supervising System was developed for patients of Sichuan new rural cooperative medical scheme (NRCMS) using the C#programming language under .NET development environ-ment based on Microsoft Visual Studio 2010 in order to solve the problems in offsite medical accounting information statistics and supervision for patients of NRCMS.The system is a B/S-based MVP 3-tier structure with VPN hard-ware firewall and VPN client software plus certificate built-in, and can thus be used to supervise the offsite medical accounting for patients of NRCMS, analyze their medical advice seeking indexes at other places, and provide data for the NRCMS fund management .

Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.

Objective To explore the clinical efficacy and safety analy-sis of moxifloxacin versus levofloxacin in the treatment of elderly patients with community acquired pneumonia ( CAP ) . Methods Sixty -two elderly patients with CAP were randomly divided into treatment group ( n=32 ) and control group ( n=30 ) .Patients in treatment group were treated with moxifloxacin 400 mg by intravenous transfusion , qd with changes for orally administration 400 mg qd after improvement.Patients in control group were treated with levofloxacin 500 mg by intravenous transfusion , qd with changes for orally administration 100 mg tid after improvement.The total course of administration was less than 2 weeks. The clinical efficacy , total course of administration , pathogenic bacteria clearance rate and safety were evaluated between the two groups . Results The total efficacy was not significant different between the two groups ( P>0.05 ) , but the cure rate in treatment group was significant higher than that in control group ( P<0.05 ) .The total course of drug administration of treatment group was shorter than control group (P<0.05).The pathogenic bacteria clearance rate was 93.75% and 83.33%for treatment and control group respectively which indicated that treatment group was significant higher ( P<0.05 ) .And the drug related
toxicity was not statistically different between the two groups ( P>0.05 ) .Conclusion Both moxifloxacin and levoflo-xacin were effective and safe in the treatment of elderly patients with community acquired pneumonia .And moxifloxacin had higher pathogenic bacteria clearance effects .

Objective To investigate the prevalence and pattern of androgenetic alopecia (AGA) in Shanghai through a community-based survey. Methods A cluster sampling survey was done among the residents in Beixinjing Community, Changning District, Shanghai. All the subjects were asked to fill a questionnaire to provide their general information, including sex, age, native place, physical status, life habit, family history, etc. The diagnosis of AGA was made by dermatologists. To determine the pattern of hair loss,Norwood-Hamilton classification system and Ludwig classification system were used for male AGA and female AGA, respectively. All the data were statistically analyzed by EpiData and SPSS11.5 software. Results Totally, 7056 subjects completed the questionnaire, including 3519 males and 3537 females, and the response rate was 72.5%. AGA was diagnosed in 809 patients, consisting of 701 males aging from 19 to 91 years (mean 64.16±11.9 years) and 108 females aging from 35 to 91 years (mean 70.46±18.89 years). The standardized prevalence (SP) was 9.47% in total, 15.73% in males and 2.73% in females; the difference was significant between males and females (χ2=356.00, P<0.001). A family history of AGA was observed in 52.7% of all subjects including 391 (55.78%) males and 35 (32.41%) females. Type Ⅲ vertex involvement was the most common type in men aging from 20 to 70 years old, and type Ⅵ in those over 70 years old. Grade Ⅰ and Ⅱ predominated in female AGA. Conclusions The results of this survey indicate that the prevalence of AGA is remarkably higher in men than that in women. Furthermore, the prevalence is steadily increased with advancing age in Shanghai.

Objective To investigate the protective effect of modified Qianjin Weijing Decoction(MQJWJD)on TNF-α and NF-κB in rats with lung injury induced by particulate matter; To discuss relevant mechanism of action. Methods A tracheal drip 15 mg/kg fine particles of saline solution was used to establish modeling, every other day, three times. Thirty-two Wistar rats were randomly divided into normal group, model group and MQJWJD high-dose and low-dose groups, with eight rats in each group. Medication groups were given relevant medicine for gavage. The level of TNF-α in bronchoalveolar lavage fluid (BALF) was measured by ELISA. The expression of NF-κB protein in lung tissues was measured by immunohistochemistry. The histopathology of the lung injury was observed by light microscope. Results Compared with normal group, the level of TNF-α and the expression of NF-κB protein in the model group were higher than those in the normal group (P<0.01). Compared with model group, the level of TNF-α and the expression of NF-κB protein in MQJWJD low-dose and high-dose groups were lower than those in the model group (P<0.05, P<0.01). Pathological observation showed that, compared with normal group, model group showed intratracheal, alveolar and interstitial bacteria within a large number of fine particles calm, alveolar and pulmonary interstitial visible large amounts of phagocytic fine particles of macrophages and accompanied by more neutrophils and lymphocyte infiltration; Lung tissue pathological changes were significantly lighter in MQJWJD high-dose and low-dose groups than the model group. MQJWJD high-dose group showed mild inflammation, alveolar and pulmonary interstitial visible phagocytic fine particles of macrophages, a small amount of neutrophils and lymphocyte infiltration. Conclusion MQJWJD can reduce the pulmonary injury in rats induced by particulate matter and has protective effects on the rat model through decreasing the levels of TNF-α and the expressions of NF-κB protein in injured lung tissues.

Objective To discuss the therapy for acetabular comminuted fractur e combined with compressive defects. Methods From July 1997 to February 2005, 43 cases of comminuted acetabular fracture combined with compressive defect were t reated. 25 cases were obsolete, 16 fresh, and 2 malformed (90 days after injury) . 34 cases were complicated fractures with defects, and 9 simple fractures with defects. The defect volumes ranged from 3 to 9 cm3, averaging 4.5 cm3. They were treated with ATMFS (acetabular tridimensional memory fixation system) to fixate the comminuted bone fragments tridimensionally. The modified acetabular approac h, reduction of acetabular comminuted articular face, anatomical reconstruction of posterior wall of acetabulum with autogenous ilium, autogenous and artificial bone implantation and bone wax isolation were used. The follow-ups lasted from 5 to 86 months, averaging 15.7 months. Results 31 cases achieved anatomical red uction by filling up the compressive defects. 12 cases were treated by anatomica l reconstruction of posterior wall. On average, 5.3 months after operation, the injured hip joint was as good as the healthy one in 40 cases. Ischemia necrosis of femoral head occurred in 1 case, and 2 cases experienced heterotopic ossifica tion with ischemia necrosis of femoral head which led to osseous fusion of hip j oint. Conclusion The new methods for treatment of acetabular fractures with comp ressive defects elevate the reduction rate of acetabulum and femoral head, and a re effective for the functional recovery of hip joint.

Objective To explore the correlationships between microperfusion diffusion indexes derived from intravoxel incoherent motion(IVIM)and perfusion values measured by arterial spin labeling (ASL)in renal allograft. Methods A total of 76 renal allograft recipients and 26 age-matched volunteers (group 0)were included in this prospective study. All subjects were underwent conventional MRI, IVIM and ASL MRI which were performed in the oblique-sagittal plane. Seventy-six recipients were divided into two groups based on the estimated glomerular filtration rate(eGFR):recipients with good allograft function(group 1, eGFR≥ 60 ml · min-1 · 1.73m-2,n=44)and recipients with impaired allograft function(group 2, eGFR<60 ml · min-1 · 1.73m-2,n=32). Three IVIM indexes values, including true diffusion coefficient(ADCslow), pseudo-diffusion coef fi cient(ADCfast), perfusion fraction(PF), and one ASL index value of renal cortex(renal blood flow, RBF)were measured. One-way analysis of variance and the least significant difference were used to compare the different of each cortical index values among three groups. Correlations between the ADCslow, ADCfast, PF, RBF and eGFR as well as the correlation among the indexes were evaluated using Pearson correlation coefficients. Results For cortical ADCslow, ADCfast, PF and RBF values, allografts with good function and impaired function showed significantly differences compared healthy controls(all P<0.01). In allografts with good function, cortical ADCslow,ADCfast,PF showed no significantly differences compared with controls(all P>0.05), but RBF value was significantly lower(P<0.05). The ADCslow, ADCfast, PF and RBF values of renal cortex were significantly lower in allografts with impaired function compared to allografts with good function(all P<0.01). In renal allografts, there were significant positive correlations between cortical ADCslow, ADCfast, PF, RBF value and eGFR(r values were 0.604, 0.552, 0.579 and 0.673, all P<0.01). Cortical ADCfast and PF value exhibited a significant correlation with RBF for recipients(r values were 0.501 and 0.423, all P<0.01). Conclusion Cortical ADCfast and PF values derived from IVIM and RBF measured by ASL show a significant positive correlation in renal allografts.

Objective To compare the application values and setup errors between vacuum bag plus body mask and customized alpha cradle duringproton and carbon therapy using Siemens 6D robotic couch in prostate cancer patients.Methods Nineteen patients received vacuum bag plus body mask setup were allocated into the vacuum bag group andl9 patients with alpha cradle were assigned into the alpha cradle group.Orthogonal X-ray portals were performed to verify the treatment position before beam delivery in every fraction.The couch correction between the portal and reference DRR through manual image registration was recorded as setup errors in 6 directions including the lateral,supine-inferior,anterior-posterior,yaws,roll and pitch,respectively.Two-tail t-test was used to analyze the setup error data from each direction between two groups.Results In total,452 and 436 sets of data errors were collected from the vacuum bag and alpha cradle groups.The average setup errors and standard deviation in the vacuum bag and alpha cradle groups in the lateral,supine-inferior,anterior-posterior,yaws,roll and pitch directions were (0.63±0.48) cm vs.(0.33±0.24) cm (P=0.000),(0.40±0.3) cm vs.(0.31±0.25) cm (P=0.000),(0.69±0.61) cm vs.(0.82±0.69) cm (P=0.006),0.65°±0.47°vs 0.32°±0.25°(P=0.000),1.05°±0.95°vs 1.16°±0.94° (P=0.100) and 0.67°±0.56°vs 0.40°±0.36° (P=0.000),respectively.The maximum setup errors were detected in the pitch direction for both groups.Conclusions During the proton and carbon therapy using Siemens 6D robotic couch,two setup methods using vacuum bag plus body mask and customized alpha cradle should be selected according to the individual conditions of patients.A customized foot fixer should be utilized to reduce the uncertainty in the femoral head region.

Objective Compared with digital subtraction angiography(DSA),to evaluate the value of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography(3D MRA) in defining hepatic arterial anatomy.Methods The data about abdominal high-resolution contrast-enhanced 3D MRA and DSA of 26 patients (24 patients with primary liver cancer,2 patients with metastatic liver tumor) was retrospectively analyzed.The display quality of different segmental hepatic artery was scored with 4 grades and the agreement between high-resolution 3D MRA and DSA was determined with the weighted Kappa statistic.The depiction of hepatic arterial anatomy/anomalies and vascular pathology on high- resolution 3D MRA was assessed and compared with DSA.Results With respect to display quality,there was good or fair correlation between high-resolution 3D MRA and DSA for the common hepatic artery (the mean score respectively was 3.96,3.96 and Kappa value 0.99),gastroduodenal artery (the mean score respectively 3.85,3.88 and Kappa value 0.85 ),right hepatic artery(the mean score respectively 3.92, 3.96 and Kappa value 0.65 ),left hepatic artery (the mean score respectively 3.77,3.92 and Kappa value 0.43 ),left gastric artery(the mean score respectively 3.73,3.85 and Kappa value 0.43 ),right anterior artery (the mean score respectively 3.35,3.70 and Kappa value 0.53),right posterior artery (the mean score respectively 3.31,3.73 and Kappa value 0.46)and 1V segment artery (the mean score respectively 2.92,3.46 and Kappa value 0.51 );Poor correlation was found for the Ⅱsegment artery (the mean score respectively 2.15,3.35 and Kappa value 0.18)and Ⅲsegment artery (the mean score respectively 2.19, 3.35 and Kappa value 0.21 ).Compared with DSA,18 normal hepatic arterial anatomy and 7 arterial anomalies were accurately demonstrated(accuracy ratio 96.1% (25/26)),the obliteration of gastroduodenal artery correctly depicted in 1 patient on high-resolution 3D MRA image.Conclusions High-resolution 3D MRA can provide accurate evaluation of hepatic artery and has the capacity of depicting hepatic segment artery.