Objective To study the association between adults'respiratory health and elements concentrations in aerometric particulate matters and provide information about the effect of air pollution sources on human health. Methods Health question nairs were administered to 7 661 male and 7 673 female adults in 4 Chinese cities. 42 elements in particulate matters of both urban and rural areas were analyzed by XRF. The data were analyzed by using two-stage regression, the Logistic regression for the first stage and weighted linear regression for the other. Adult's respiratory health parameters were obtained by 1st stage analysis. The association of the elements in PM and adults'respiratory health parameters of 8 sites in the 4 cities was established. Odds ratios were given using the weighted linear regression model. Results Positive associations between adults'respiratory health and crust elements (Al, Ca, Fe, Si, Ti) and pollution elements (As, Ni, Cd, Pb) in PM2.5-10 or PM2.5 were found (OR=1.00-1.12). Associations of respiratory health parameters with elements in fine particle (OR=1.03-1.61) were stronger than those with elements in coarse particle (OR=1.03-1.12) in the case of the equal element concentrations. Conclusion An assumption of 'crust particle groups' was brought forward to give an explanation to the relation between crust elements and respiratory health. It assumed that the relation is an indirect one, since 'crust particle groups' in PM act as carrier of toxic matters and/or bacteria. The result points out that it should pay much attention to controlling of PM from soil as well as controlling of industrial pollution.

BACKGROUND: Gallie, Brooks steel wire, and Halifax vertebral plate clamp are tools for internal fixation of atlas-axis joint. They can keep the flexion-extension stability of atlas-axis joint, but weaken the ability to against lateral bending and rotation. Magerl+Gallie implantation shows good biomechanics stability, but cannot well prevent axial dislocation. OBJECTIVE: To introduce the surgical technique from posterior approach for atlas, and explore the effect on biocompatibility and biomechanics of implants. RETRIEVAL STRATEGY: The articles related to atlas-axis joint dated between January 1970 and June 2007 were retrieved through Pubmed, PML, OVID and Wanfang database using of "atlas, axis, dislocation, fixation, posterior" and "atlas, dislocation, internal fixation, implant, posterior approach, biocompatibility, biomechanics" in Chinese. All collected articles were selected firstly and the articles related to implants, surgical skills, and biomechanics were selected. For articles in identical field, only those published in recently or in authoritative journals were selected. Repetitive articles and Meta analysis were excluded. 127 articles met the criteria and 30 of them were involved. LITERATURE EVALUATION: The articles involved were related to the surgical treatment of dislocation of atlas-axis joint. Of 30 articles, 3 were review articles, 3 were monographs, and the others were clinical or basic researches. DATA SYNTHESIS: ①Lateral mass and pedicle screw implantation techniques can achieve three-dimensional fixation. ②The screw entrance points of atlantoaxial pedicle screw implantation is higher than lateral mass technique, it is unnecessary to expose C1, posterior arch and other deep parts of anatomic structures. C2 nerve root and venous plexus are not separated completely, which reduce injury rate and blood loss. In addition, screw passage of pedicle screw is longer than Harms technique, so screw can completely contact with skeleton to enhance the fixation. CONCLUSION: Atlantoaxial fixation by posterior pedicle screw implantation shows good biomechanics and biocompatibility. It may become the optimal approach for atlantoaxial short segmental fixation.

OBJECTIVE To investigate the evolution of drug-resistance of Staphylococcus aureus in children in Hubei tertiary level hospitals during four years and provide the evidence for clinically reasonable use of antibiotics.METHODS The summary data of drug sensitivity in clinical isolates of meticillin-resistant S.aureus(MRSA) and meticillin-sensitive S.aureus(MSSA) in children in Hubei tertiary level hospitals from 2004 to 2007 were investigated retrospectively and the results were analyzed statistically.RESULTS The tendency of infections with MRSA upgraded yearly during four years(5.7%→10.7%→40.8%→46.9%);the resistance rates of MRSA to various antibiotics were all higher than that of MSSA.The vancomycin-resistant S.aureus had not been detected.CONCLUSIONS The drug-resistance status of SA in Hubei is still very serious.We should adopt effective measurement to control the occurring and epidemic outbreak in combination with children physiological characteristic.

Objective To investigate the clinical efficacy and safety of sitagliptin combined with metformin in treating patients with type 2 diabetes with non-alcoholic fatty liver diease (NAFLD).Methods Sixty-five patients with type 2 diabetes with non-alcoholic fatty liver admitted into our hospital from June 2012 to June 2015 were randomly divided into two groups.Thirty-three patients in control group were treated with metformin only,and thirty-two patients in observation were treated with sitagliptin combined with metformin.The changes in body mass index (BMI),fasting plasma glucose (FPG),2-hour postprandial glucose (2hPG),Hemoglobin Ale (HbAlc),homeostasis model assessment of insulin resistance (HOMA-IR),and liver function index including that aminopherase of alanine acid (ALT),aminopherase of aspartic acid (AST),gamma-glutamyl transterase (GGT),triglyceride (TG),and total cholesterol (TC) were detected before and after 16 weeks of treatment.And the total effective rate and safety were analyzed and compared.Results After treatment,HOMA-IR,FPG,2hPG,HbA1c,ALT,AST,GGT,TG,and TC were remarkable improvement (P ＜ 0.05),and HOMA-IR,HbA1c,AST,ALT,GGT,and TG were significantly better than those of control (P ＜ 0.05).Additionally,the total effective rate in observation group with 90.9％ was significantly higher than that of control group with 42.4％ (P ＜ 0.05).And difference in incidences of adverse effect between observation group with 15.6％ and control group with 9.1％ were not significant.Conclusion Sitagliptin combined with metformin treatment had a good ability on treating patients with type 2 diabetes with NAFLD by improvement of metabolic syndrome and liver function.

Systemic juvenile idiopathic arthritis (sJIA) is a systemic inflammatory disease characterized with arthritis in one or more joints,fever,rash and serositis.Due to the atypical symptoms and poor prognosis,it's a great challenge in the clinical diagnosis and treatment efficacy evaluation in sJIA.These challenges could be addressed by the identification of clinical biomarkers,aiming at evaluating the disease severity,predicting the activity and prognosis of sJIA.This review will be focus on genetics,serum and cellular markers in sJIA and summarize the relative application on diagnosis and treatment.

Objective To study the clinical effect of surgery combined with antifungal drug in treatment of fungal nose-sinusitis.Methods The clinical data of 108 cases with fungal nose-sinusitis were retrospectively analyzed.All patients were treated with nasal endoscopic sinus surgery.According to whether the patients received antifungal drugs after low-temperature plasma-assisted surgery,the patients were divided into the treatment group and the control group.The treatment group(56 cases) was given antifungal fluconazole after low-temperature plasma-assisted endoscopic sinus surgery.52 cases in the control group were washed by 0.9％ sodium chloride solution after conventional endoscopic sinus surgery.The patients were followed up for 6 months to 2 years,the therapeutic effect and recurrence were compared between the two groups.Results 56 patients of the treatment group,49 cases were cured,7 cases improved,no recurrence.52 cases in the control group,47 cases were cured,improved in 4 cases,ineffective in 1 case,3 cases of recurrence.The recurrence rate of the treatment group was significantly lower than the control group (x2 =4.82,P ＜ 0.05).Conclusion The low-temperature plasma-assisted surgery combined with antifungal drug.in the treatment of fungal nose-sinusitis has exact efficacy,and has significant effect on the prevention and reduce the relapse rate,which worthy of clinical promotion.

Objective To compare the curative effect of several surgical treatments for closed urethral injury.Methods A retrospective study was done on 200 cases of closed urethral injury treated with various methods from June 2002 to June 2012,including 44 cases of anterior urethral injury treated with endoscopic transurethral realignment (anterior endoscopic group),32 cases of anterior urethral injury with transperineal urethral repair (repair group),42 cases of posterior urethral injury with transperineal urethral termino-terminal anastomosis (anastomosis group),35 cases of posterior urethral injury with endoscopic transurethral realignment (posterior endoscopic group),and 47 cases of posterior urethral injury with endoscopic transurethral and transvesical realignment (combined endoscopic group).Amount of bleeding,operation time,hospital stay as well as expense,and rate of urethral stricture and erectile dysfunction (ED) in treatment of anterior and posterior urethral injury were compared respectively.Curativeeffect and merits and faults of each treatment were observed.Results Anterior endoscopic group achieved less bleeding [(10 ± 5) ml∶ (100 ± 20) ml,P ＜ 0.05],shorter operation time and hospital stay [(15 ± 6) min∶ (40 ± 15) min,(14.2 ± 1.8) min∶ (28.5 ± 1.5) min respectively,P ＜ 0.05],lower hospital expense and urethral stricture rate[(4 715.42 ± 225.43) RMB∶ (6 886.46 ± 246.78) RMB,39％ ∶ 63％ respectively,P ＜ 0.05] as compared with repair group,but there was no statistical difference in ED rate between the two groups.Whereas in anastomosis group,the most bleeding [(200 ± 30) ml],longest operation time [(60 ± 20) minutes] and hospital stay [(28.7 ± 2.3) days],and highest hospital expense [(6 964.27 ± 275.69) RMB] and urethral stricture rate (95 ％) were detected (P ＜ 0.05).Posterior endoscopic group presented less bleeding [(15 ± 6) ml∶ (50 ± 12) ml,P ＜ 0.05] and shorter operation time [(21.4 ± 1.7) min∶ (21.2 ± 1.5) min,P ＜ 0.05] as compared with combined endoscopic group,but there were no statistical differences in hospital stay as well as expense and urethral stricture rate between the two groups.Moreover,ED rate was not statistically different among anastomosis group,posterior endoscopic group and combined endoscopic group.Conclusions Endoscopic surgery is superior to traditional surgery in terms of blood loss,operation time,hospital stay,and hospital cost.Besides,urethral stricture and ED rates are closely related to the location and severity of injury.

Digital subtraction angiography has long been recognized as a gold standard for detecting cerebrovascular lesions.With the development of CT techniques,CT angiography(CTA)has been widely used in intracranial and extracranial vascular evaluation.This article reviews the development of CTA technique and its application in the diagnosis of cerebrovascular lesions.

Objective Investigate the diagnosis and treatment of 9 cases in humeral shaft fracture combined with brachial artery injury. Methods 9 cases of humeral shaft fracture combined with brachial artery injury were treated. Results 1 patient was carried out amputation because severe soft tissue injury, obvious limb swelling after operation and occurring thrombosis. The muscles of 2 cases was ischemic and contracture, functional poor because of visiting late. The remaining 6 cases as a result of the diagnosis and treatment in a timely manner, postoperative function were satisfactory. Conclusion Timely diagnosis and treatment for patiends of humeral shaft fracture combined with brachial artery injury can have the good clinical results.

Several of the genetic models and environmental risk factor models were used in the animal model study in autism.The BTBR T+ Itpr3tf(BTBR) mice are an inbred strain and have emerged as strong candidates to serve as models of a range of autism-relevant behaviors, showing deficiencies in social behaviors and reduced or unusual ultrasonic vocalizations as well as increased repetitive self-grooming.There are increasing investigations targeted to ameliorating the behavioral phenotypes of autism in BTBR mice.This review briefly summarizes the advance in the research on the BTBR mice model of autism.