Objective To verify the safety of non-thoracoscopic Nuss procedure,and review our experience in correction of pectus excavatum by Nuss procedure with post-implantation thoracoscopic assistance.Methods 191 patients with pectus excavatum were surgically corrected by Nuss procedure with post-implantation thoracoscopic assistance.There were 146 boys and 45 girls,The age ranged from 2.8 to 20 years with mean age was ( 6.46 ± 3.36) years.Hailer' s index was 4.68 ± 1.84.The operation was performed under Non-thoracoscopic assistance first and then with thoracoscopic observation.Results The operation in all patients had been performed successfully.The time of the operation ranged from 27 to 50 minutes with mean time was ( 32.49 ± 2.79) minutes.The average bleeding volume during procedure was ( 2.19 ± 0.87 ) ml.The durstion of follow-up was 10 to 23 months.All patients have been satisfied with their surgical correction.The postoperative complication was 13 cases( 6.81％ ).The bar outsides the pleura in both sides was 18 cases( 9.42％ ).The bar outsides the right pleura was 23cases( 12.0％ ).The bar outsides the left pleura was 17 cases( 8.90％ ).Conclusion Nuss procedure with non-thoracoscopic assistance for correction of poctus excavatum is safety if the surgeon experienced and have certain methods.Post-implantation thoracoscopic Nuss procedure is safer,and can deal with the damage caused by non-thoracoscopic assistance.

Objective To summarize the experience of diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children.Methods The data of 91 patients with pectus excavatum associated with congenital pulmonary disease was collected from July 2002 to August 2010 in Beijing Children's Hospital.There were 64 males and 27 females.30 patients with pectus excavatum associated with congenital pulmonary cyst,congenital cystic adenomatoid malformation,pulmonary sequestration,and some severe cases of congenital lobar emphysema received the Nuss surgery and lobectomy simultaneously.Results 30 cases with pectus excavatum asseeiated with congenital pulmonary disease received simultaneous Nuss procedure and lobectomy.All cases were confirmed by pathology and recovered uneventfully.Conclusion Chest CT scan is an effective way to evaluate pectus excavatum associated with pulmonary diseases.Whether surgery is needed for the pulmonary disease depend on the specific types of disease,age and other various factors.Simultaneous surgery for pectus excavatum and pulmonary disease can lower the risk of the multiple operations,and reduce the financial burden of famihes.

Objective To study the biological exposure limit in bone metabolism damage caused by coexposure to fluorine and arsenic from coal burning in exposed population.Methods One hundred and ninety-eight cases of fluoride and arsenic co-exposed people from Liuchang village,Qinzhen city,Guizhou province were enrolled in the study.Urinary fluorine (UF),urinary arsenic (UAs),urinary hydroxyproline (UHYP),ross-linked Ntelopeptides of type Ⅰ collagen(UNTX) and bone strength index(STI) were detected.BMDS Version 2.1 software was used to calculate UF,UAs benchmark dose (BMD) and its lower confidence limit (BMDL) on the damage of bone metabolism caused by co-exposure to fluorine and arsenic from coal burning.Results The BMD and BMDL range of UF caused by co-exposure to fluorine and arsenic from coal burning were 0.68-1.35 mg/g Cr,0.57-1.11 mg/g Cr.The BMD and BMDL range of UAs caused by co-exposure to fluorine and arsenic from coal burning were 8.36-18.77 μg/g Cr,7.12-15.40 μg/g Cr.Conclusion The biological exposure limits of UF and UAs for bone metabolism toxicity are proposed as 0.57 mg/g Cr and 7.12 μg/g Cr in co-exposure to fluoride and arsenic from coal burning,respectively.

Objective To compare the safety and feasibility of thoracoscopic extrapleural Nuss procedure with traditional intrapleural Nuss procedure. Methods Total 252 patients with pectus excavatum received Nuss surgery from July 2008 to June 2009 in Beijing children' s hospital. Patients had following condition were excluded; (1) recurrent pectus excavatum; (2) complicated with other diseases, and need simultaneous surgery; (3) older than 13-year-old; (4) extensive depression, and need two Nuss bar; or (5) extreme severe or severe unsymmetric. 131 cases were selected in our study and they were randomly divided into two groups, thoracoscopic extrapleural Nuss procedure ( n = 62 ) and traditional intrapleural Nuss procedure ( n =69). Perioperative information, postoperative complications, effectiveness and the location of the Nuss bar were compared between two groups. Results All the 131 patients had completed the procedure successfully. There were no significant differences in age, Haller index; surgical effects, operation time, blood loss, and hospital stay, between two groups. Postoperative complications between the two groups are not significant. 131 patients were followed up from 14 to 26 months, and no recurrence and long-term complications occurred. About more than half cases of extrapleural Nuss procedure group were break the pleural into thoracic cavity. Conclusion Both extrapleural and intrapleural Nuss procedure are safe and effective for pectus excavatum, but extrapleural Nuss procedure have no advantage to the intrapleural Nuss procedure, also it' s hard to observe the other side of thoracic cavity during the surgery, and not easy to grasp and to promote.

Objective To explore the serum level of gentamycin for orally in children with serious illness.Methods The serum level of gentamycin in 41 children who were in serious illness [multiple organ dysfunction(MODS)group with 21 cases and non-MODS group with 20 cases ] were monitored and the patients were treated with select decontamination of the digestive tract(SDD) from October 2004 to April 2005.Dosage:10 mg/(kg?d),orally taken three times(every 8 hours) one day.The blood after taking the drug one hour later in the fourth day was selected and the serum level of getamycin was monitored.Results Thirty-six children of 41 cases serum level of gentamycin were negative and 5 children(4 in MODS group and 1 in non-MODS group) who had alimentary tract hemorrhage were masccline in serum after taking gentamycin one hour later in the forth day.The absorption of gentamycin from enteric after orally was not(rela)-ted to MODS.There were statistics value between the gestrintestinal tract ulcer and serum level of gentamycin.Conclusions The safety for treating the children in serious illness with gentamycin for SDD is obvious.But we suggest to monitor the serum level of gentamycin for who has severe alimentary tract hemorrhage together with insufficiency of liver and kindey.

OBJECTIVE: To select specific DNA aptamer for determining ketamine by FluMag-SELEX. METHODS: Based on magnetic beads with tosyl surface modification as solid carrier and ketamine as target, a random ssDNA library with total length of 78 bp in vitro was compounded. After 13 rounds screening, DNA cloning and sequencing were done. Primary and secondary, structures were analyzed. The affinity, specificity and Kd values of selected aptamer were measured by monitoring the fluorescence intensity. RESULTS: Two ssDNA aptamers (Apt#4 and Apt#8) were successfully selected with high and specific abilities to bind ketamine as target with Kd value of 0.59 and 0.66 μmol/L. The prediction of secondary structure was main stem-loop and G-tetramer. The stem was the basis of stability of aptamer's structure. And loop and G-tetramer was the key of specific binding of ketamine. CONCLUSION FluMag-SELEX can greatly improve the selection efficiency of the aptamer, obtain the ketamine-binding DNA aptamer, and develop a new method for rapid detection of ketamine.
Aptamers, Nucleotide/metabolism* ; DNA ; DNA, Single-Stranded/genetics* ; In Vitro Techniques ; Ketamine/metabolism* ; Oligonucleotides ; SELEX Aptamer Technique/methods*

Objective To investigate the expression of survivin/Human leukocyte antigen class I ( HLA-Ⅰ) proteins and its physiological significance in clear cell renal cell carcinoma ( CCRCC ) . Methods Immunohistochemistry was used to analyze survivin/HLA-Ⅰ protein expression in 90 cases of CCRCC and 10 normal tissues to study relationships with clinical symptoms and disease prognosis . Resutl s The level of survivin protein expression was found to be significantly higher in CCRCC tissues 82.2%( 74/90) than in normal tissues( 0/10).However, the relative amount of HLA-Ⅰprotein in colorectal cancer tis-sue was also found to be significantly lower 67.8%(61/90) than in normal tissues 90%(9/10).Survivin expression was associated with tumor grade , stage,and lymph node metastasis ( P=0.000, P=0.016, and P=0.001, respectively ) .Conversely , lost HLA-Ⅰexpression did not have any associations with clinicopath-ological data (P>0.05).Survivin negative patients (25.0%, 4/16) had a higher tumor-free survival rate than patients (52.7%, 39/74)with survivin expression (P=0.037).Patients (27.6%, 8/29) with normal HLA-Ⅰlevels had a higher tumor-free survival rate than those ( 60.7%, 37/61) with reduced HLA-Ⅰlev-els (P=0.020).The univariate and multivariate analyses indicated that expression of survivin and HLA indi -vidually and in combination were independent predictors for CCRCC patient survival . Conclusions Over-expression of survivin but reduced HLA-Ⅰ expression is associated with CCRCC development and progres-sion.

Objective To access the development of thoracic volume of pectus excavatum use of Nuss operation used CT-basedpulmonary volumetric evaluation.Methods 98 patients with pectus excavatum in Beijing Children's Hospital under Nuss operation were documented.All patients had CT scan pre-and postopration.The CT-scan's data were calculated as lung's volume by handdraw-layers summation method.The lung's volume result was compared,and enquiry the position in CT lung volume developmental scale.Results The lung's volume was elevated 28.3％ after operation.The development of thoracic volume was keep with age,70％ was maintained and 15％ was elevated.Conclusion Nuss operation can prevent the decrease of thoracic volume in pectus excavatum.

Calibration ; Chemistry Techniques, Analytical ; methods ; Humans ; Lead ; blood

This study aimed at investigating the utilization of TCM services and exploring the influencing factors,such as education,economic condition,health condition,attitude to TCM treatment and TCM health literacy,of TCM treatment-seeking behavior in the elders in Zhejiang Province.In this study,a cross-sectional study with stratified sampling was adopted for the further investigation of the elders over 55 years by questionnaire.The questionnaire contained four aspects:1.demographic information:gender,age,education,pension mode,medicare and self-evaluation of economic level;2.health status:self-evaluation of health and current diseases;3.attitude to TCM treatment:Would you accept the TCM health services? 4.health literacy:self-made KAB questionnaire including health knowledge,attitude and behavior.Nine hundred and fifty questionnaires were issued and 945 valid questionnaires were returned.Among them,four hundred and eighty-four cases were male and 461 were female.The average age was 72.0 ± 8.9 years with a low level of education,mainly junior high school or lower (88.3％).Over the past year,only 50.11％ elders sought for TCM treatment.Generally speaking,age,gender,education,pension mode and health behavior showed no significant association with TCM treatment.The elders seeking for TCM treatment over the past year held favorable attitude to TCM treatment and high economic status,yet,with poor health status,high prevalence and health literacy (or health attitudes).It was concluded that the utilization rate of TCM services in the elders in Zhejiang Province was not optimist,probably resulting from the lack of publicity and market competitiveness of TCM.Therefore,TCM services should be promoted to meet the health needs of the elders and enhance the utilization rate of TCM services for the achievement of a significant role in the aging society in China.