Objective To explore the prevalence of multilevel lumbar spondylolysis in operation patients,and to evaluate the diagnostic value of CT reconstruction on multilevel lumbar spondylolysis.Methods A total of 312 patients,who had undergone surgical treatment in our hospital from January 2004 to March 2012 for lumbar spondylolysis,were enrolled in this study.There were 147 males (47％) and 165 females (53％),aged from 12 to 76 years (average,44 years).Every patient underwent lumbar spine X-ray examination including anteroposterior,lateral,over-flexion,over-extension and double oblique X-rays,as well as CT examination.The prevalence of multilevel lumbar spondylolysis in all operation patients and the involved segments were recorded and analyzed.Moreover,the clinical manifestation and radiological features were summarized.Results In all enrolled patients,there were 9 patients (2.9％) with multilevel lumbar spondylolysis,including 5 males and 4 females,aged from 21 to 51 years (average,39 years).As for lesion distribution,there were 8 cases of bilateral spondylolysis located at both L4 and L5,and 1 case of bilateral spondylolysis at L5 combined with right spondylolysis of L4 and discontinuity in the base of left pedicle of L4.Among 9 patients,only 3 patients obtained correct diagnosis by anteroposterior and double oblique X-rays of the lumbar spine,while all patients got final diagnosis by sagittal and oblique coronal reconstruction of lumbar spine CT scan.The oblique coronal CT reconstruction could show the details of bone defect in lumbar vertebral isthmus,bony callus,peripheral osteophytes,as well as fibroplasia.For unilateral lumbar spondylolysis,the oblique coronal CT reconstruction could also show the reactive sclerosis in contralateral lamina of vertebra.Conclusion Multilevel lumbar spondylolysis is not rare in operation patients,and L4 and L5 are most common involved levels.Sagittal and oblique coronal reconstruction of lumbar spine CT scan is more accurate in showing the details of lumbar spondylolysis,which is helpful in decreasing the missed diagnosis and improving therapy.

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Objective To investigate the current situation of iodine deficiency disorders and the effect of control measures in Sanmenxia city of Henan province, and to formulate targeted control measures for iodine deficiency disorders. Methods In 2008, five villages(offices) were selected according to the east, west, south,north and center position in each county in 6 counties(cities, districts) of Lingbao, Shan, Hubin, Yima, Mianchi,and Lushi in Sanmenxia city. One primary school was selected in each village(office), fifty students aged 8 - 10 in each primary school were randomly selected to check thyroid and their urine and edible salt were collected to detect iodine. Thirty 5th-grade students in each school were selected to carry out the questionnaire survey of health education about iodine deficiency disorders. According to the east, west, south, north and center position, five potable water samples were selected to detect iodine in the village where the primary school was in. Questionnaire survey was also carried out among ten housewives in the village. Thyroid was examined by palpation;ammonium persulfate digestion-arsenic cerium catalytic spectrophotometry(WS/T 107-2006) was used to detect urinary iodine;direct titration(GB/T 13025-1999 ) was used to detect salt iodine;arsenic cerium catalytic spectrophotometry (GB/T 5750.5-2006) was used to detect water iodine. Results One thousand and five hundreds children aged 8 - 10 were analyzed in 6 counties(cities, districts), the rate of goiter was 3.30%(50/1500), the median of urinary iodine was 273.15 μg/L. One thousand and five hundreds salt samples were detected, the coverage rate of iodized salt was 99.93% (1499/1500), the qualified rate of iodized salt was 98.00% (1469/1499), the edible rate of qualified iodized salt was 97.93% (1469/1500), the coverage rate of non-iodized salt was 0.07% (1/1500), the median of salt iodine was 28.9 mg/kg. One hundred and fifty water samples were collected, the median of water iodine was 2.76 μg/L. The pass rate of the questionnaire survey of health education about iodine deficiency disorders was 97.11% (874/900) in students and 98.67% (296/300) in housewives, respectively. Conclusions The prevention and control of iodine deficiency disorders has achieved significant results and the monitoring indicators have reached the national standard for eliminating iodine deficiency disorders in Sanmenxia city.

The asialoglycoprotein receptor (ASGPR) was used to mediate drug carrier for hepatic targeted drug delivery, this article showed the enzyme-catalyzed esterification of galactose and vinyl stearate and a kind of ASGPR ligand-targeted which was used to insert the surface of liposome has been synthesized. The structure of product has been confirmed by TLC, ESI-MS and 1H NMR. The factors of types and quantity of enzyme, organic solvents, molar ratio of substrate, temperature and time of reaction have been studied. Results showed when using acetone as reaction medium, the quantity of Novozym 435 immobilized lipase was 30 mg mL(-1), molar ratio of galactose to vinyl stearate was 1:5, and reacted at 60 degrees C for 12 h, the transformation of vinyl stearate reached more than 70%. This study provides a novel and efficient route to the synthesis of ligand-targeted modifier.

Craniofacial Abnormalities ; Humans ; Infant, Newborn ; Male ; Skull ; abnormalities

Adolescent ; Alkanes ; poisoning ; Alkenes ; poisoning ; Daphne ; chemistry ; Humans ; Male

Administration, Oral ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Peracetic Acid ; administration & dosage ; poisoning ; Poisoning ; diagnosis ; therapy

Objective In order to provide the basis for establishment of food allergy models , we compared the differences of sensitivity and alterations of intestinal flora of food allergy models in two strains of mice .Methods Forty 4-5-week old female BALB/c and Kunmimg mice were divided into control group ( n=10) and food allergy goup ( n=30), respectively.Ovalbumin (OVA) was injected to the mice to establish food allergy models .Serum OVA-specific IgE of the mice was assayed by ELISA .The jejunum tissue was examined by pathology with HE staining .The changes of fecal flora were detected by denaturing gradient gel electrophoresis (DGGE).Results (1)Among the sensitized 60 mice, OVA-sIgE levels were significantly increased in 27/30 BALB/c mice and 21/30 KM mice compared with those of control groups(P<0.001).Moreover, there were more evident inflammatory cell infiltration , epithelial cell shedding and cytolysis in the jejunal villi of BALB/c mice than those of KM mice.(2) After food allergy modeling, there were significant changes of intestinal flora in the BALB/c mice (P<0.001), while only significant change of evenness was found in the KM mice (P<0.05).(3)There were changes of abundance , Shannon index and evenness of intestinal flora in the model groups of BALB/c and KM mice.Conclusions BALB/c mice are more sensitive to OVA allergy than KM mice .The composition of intestinal flora is different among different strains of mice .The changes of intestinal flora after OVA challenge in BALB /c mice are more obvious than those in KM mice .

Objective To investigate the effect of perioperative pulmonary infection in elderly patients with mild to moderate chronic obstructive pulmonary disease (COPD) undergoing general anesthesia.Methods Forty elderly patients undergoing general anesthesia and abdominal surgery, 24 males, 16 females, aged 65-81 years, ASA physical status Ⅰ-Ⅲ, BMI 19-28 kg/m2, were randomly divided into two groups (n=20 each): protective ventilation group (group PV) and conventional ventilation group (group CV).Lung protective ventilation was received in group PV: intermittent positive pressure ventilation, tidal volume 6 ml/kg (ideal body weight), positive end expiratory pressure (PEEP) 5-10 cm H2O, alveolar recruitment maneuver every 30 minutes;conventional ventilation was received in group CV: intermittent positive pressure ventilation, tidal volume 10 ml/kg (ideal body weight), without using the PEEP and alveolar recruitment maneuver.Venous blood samples for interleukin 6 (IL-6) and interleukin-8 (IL-8) were taken at five different time points: before the anesthesia induction (T1), 2 h after mechanical ventilation (T2), at the end of operation (T3), 6 h (T4) and 24 h (T5) after operation.The clinical pulmonary infection score (CPIS) was recorded at before anesthesia, days 1, 3, 5 and 7 after surgery.The incidence of postoperative pulmonary inflammation was also recorded.Results There was no statistical difference in the two groups with respect to age, body mass index, ASA physical status, intraoperative volume of infusion, estimated blood loss, urine volume, mechanical ventilation time, operation method and IL-6, IL-8 levels at T1-T5.Compared with T1, the IL-6 and IL-8 levels in two groups at T2-T5 increased significantly (P＜0.05).Compared that before anesthesia, CPIS in group CV on postoperative days 1, 3 and 5 increased significantly (P＜0.05);compared with group CV, CPIS and the incidence of postoperative pulmonary inflammation in group PV reduced significantly on postoperative days 1, 3 and 5 (P＜0.05).Conclusion Lung protective ventilation can not reduce perioperative IL-6, IL-8 levels in laparotomy elderly patients with COPD, but it can reduce the incidence of pulmonary inflammation and pulmonary infection within 5 postoperative days.

OBJECTIVE: To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians. METHOD: To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. RESULT: After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. CONCLUSION If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
Humans ; Postoperative Complications ; Postoperative Period ; Tracheoesophageal Fistula ; pathology ; surgery ; Wound Healing