Objective To investigate the trend of the national Kaschin-Beck disease condition, and provide the scientific basis for the government to make preventing strategy. Methods The data were collected from national surveillance on Kaschin-Beck disease(KBD) condition from 2000 to 2007 by restrospective method. The national X-ray detective rates and KBD condition in the eastern and western areas of China were analyzed. Results Monitoring data were collected from 189 monitoring points in 14 provinces of China, and 21 287 X-ray films were photographed of right hands of children from 2000 to 2007. X-ray detective rate was decreased significantly of national KBD from 2000 to 2007. The condition in the west of China is slightly more serious than the eastern areas, but the average of X-ray detective rate was also decreased from 21.75% to 7.30%. National condition is basically controlled. X-ray detective rate had been controlled below 5%, exept for Qinghai, Tibet and Inner Mongolia and so on. Conclusions Ninty percent of the wards have reached the controlled level according to the X diagnosis standard. In terms of the severity of the disease, most of the wards are occupied by patients with slight condition, 10% ward with moderate condition, less than 1% ward with serious condition.

Acupuncture has remarkable effects of pain relieving and functional restoration on injuries of soft tissue and joint due to military training. As more and more attention has been attached to the impact of psychological states and biorhythm disorder on the fighting ability of military staff, acupuncture has found its place in treating chronic fatigue, combat stress reaction, traumatic brain injury and post-traumatic stress disorder as well as regulating circadian rhythms. The therapeutic effect of acupuncture in military training-related physical damage and psychological trauma has already been proved by numerous clinical practices and researches. It is held that using acupuncture as an alternative could not only save medical resources, but also enhance the fighting ability of the army. However, the current clinical studies is facing the problem of limited sample size. Therefore, randomized controlled trials in large scale and multiple centers should be further carried out toward military staff, so as to provide more speaking evidences to the prevention and treatment of physical and psychological diseases.
Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Military Personnel ; psychology ; Pain Management ; Stress Disorders, Post-Traumatic ; therapy ; Wounds and Injuries ; therapy ; Young Adult

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.

Objective To evaluate the feasibility of lobectomy by completely Video-Assisted Thoracoscopic Surgery (cVATS) in the management of bronchiectasis.Methods Between June 2001 and October 2010,a total of 60 major lobectomies were performed in our single center on 32 female and 28 male patients of bronchiectasis,with a mean age of 43.4( range 17 to 69)years.All lobectomies were carried out anatomically and divided into thoracotomy group and cVATS group.Pulmonary vessels and bronchus were dissected by endo-cutters.Conversion to a thoracotomy took place if severe adhesion or bleeding was encountered.Results The operations included 5 lobectomies of right upper lobe,3 of middle lobe,6 of right lowerlobe,3 of left upper lobe,26 of left lower lobe,10 of left lower lobe plus lingular segment,4 of left pneumonectomy,1 of bi-lobectomy,1 of right middle lobe plus wedge resection of lower lobe and 1 of left lower lobe plus right middle lobe.There were 25 patients in the thoracotomy group and 35 patients in the cVATS group,in which 2 operations (5.7％) converted due to severe adhesion,poor differentiation of the fissure and/or the proliferation of tortuous vessels at hilus In thoracotomy and cVATS groups,the operative time were ( 207.6 ± 88.5 ) vs.( 168.7 ± 55.9 ) min ( P =0.041 ),the blood loss were ( 522.0 ±644.2) vs.(210.1 ± 213.1 ) ml ( P =0.009),the mean chest tube duration were ( 5.4 ± 4.4) vs.(6.3 ± 3.4 ) days ( P ＞0.05 ) and the mean length of hospitalization were ( 10.2 ±4.7 ) vs.( 8.5 ± 3.5 ) days ( P ＞ 0.05 ).No mortality or severe complication occurred in both groups.The morbidity was 25.7％ (9/25)vs.17.1％ (6/35) in thoracotomy and cVATS group,with no significant difference statistically (P =0.133 ) . There were 52％ vs.62.9％ patients achieved symptomatic completely relief and significant improvement was obtained in 40.0％ vs.31.4％ patients in thoracotomy and cVATS group separately.Conclusion cVATS lobectomy is safe and effective in the management of bronchiectasis.

Objective To investigate the effect of aluminum on hair loss induc ed by fluoride in fluorosis mice.Methods Sixty male C57BL mice were divided into four groups according to body mass:control group,fluoride (F) group (F-100 mg/L),aluminum(Al) group(Al3+ 270 mg/L) and F + Al group(F-100 mg/L + Al3+270 mg/L).Mice were killed 1 month and 3 months after the experiment,respectively.Bone F content was detected by ion-selective electrode method.The level of bone Al was measured through inductively coupled plasma emission spectrum.Dental fluorosis and hair loss of mice were evaluated by visual method.Results One month after the experiment,no dental fluorosis and hair loss was found in all four groups.The content of bone F was the highest in F group [(2401.649 + 86.835) mg/kg],and the lowest in A1 group [(427.006 + 11.878) mg/kg].The levels of bone F in F + Al group and control group were (1210.332 + 19.531)mg/kg and (538.001 + 33.337)mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Three month after the experiment,all mice of F treatment group had dental fluorosis and hair loss(10/10).Alopecia areas were found in the neck and back regions only.There was no hair loss in control group,Al group and F + Al group.No dental fluorosis was found in both control and Al groups.Only 2 mice were found with dental fluorosis in F + Al group.The levels of bone F in F group,F + Al group,control group and Al group were (4098.645 + 58.842),(1888.165 ± 12.187),(876.258 + 14.462) and (662.385 ± 8.966) mg/kg,respectively.The difference was statistically significant between any two groups (all P ＜ 0.05).Conclusions The hair loss is found in fluorosis mice.Hair loss of mice is closely associated with the level of F exposure.Al can prevent the occurrence of hair loss induced by F in mice through reducing the accumulation of F.

Background Rigid gas permeable (RGP) contact lens,as a kind of new correction of refraction error,has been wildly used,but whether it will cause eye optical system of the change and influence on the visual acuity is unclear.Objective Present study was to evaluate and compare the visual quality of low to moderate myopia following wearing of RGP contact lens and spectacles.Methods Sixty-eight eyes of 35 subjects with low or mediate myopia were included in this study.Wave-front aberrations and visual acuities under the different contrasts (10％,30％,40％,52％,76％,92％) in the light or dark environment were examined before and 3 months after wearing of RGP corneal contact lens.These parameters were compared with those after wearing of spectacles with paired t test.Results The best corrected visual acuity (BCVA) was improved significantly from 0.94±0.10 to 1.26±0.03 3 months after wearing of RGP corneal contact lens (t=-9.266,P=0.000).After fitting of RGP corneal contact lens,the total higher order wave-front aberrations,the 3rd and 4th order aberrations were significantly declined in comparison with those of before fitting (total:t=4.683,P=0.000;RMS3:t=4.656,P=0.000;RMS4:t=3.929,P=0.000).However,no significant differences were detected in the 5th and 6th order aberrations between RGP corneal contact lens fitting and spectacles wearing (RMS5:t=1.766,P=0.083 ;RMS6:t=1.150,P=0.256).In both bright and dark environments,BCVA values were much better in the eyes with RGP corneal contact lens wearing than that in the eyes with spectacles wearing (all P＜0.05).The BCVA was always reduced with the decline of contrast level whether bright or dark backgrounds both in RGP corneal contact lens wearing eyes and spectacles wearing eyes.Conclusions Wearing of RGP corneal contact lens provides better visual quality for low to moderate myopia than the spectacles wearing.

To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.

Objective To investigate the incidence and clinical presentation of breast milk transmitted cytomegalovirus (CMV) infection among preterm infants with birth weight≤1500 g.Methods Preterm infants enrolled in this study met the following inclusion criteria: birth weight≤1500 g, fed with CMV-positive breast milk and admitted into Neonatal Intensive Care Unit of Children's Hospital of Fudan University within 72 hours after birth from October 2015 to July 2016. And those with congenital digestive tract malformation or congenital CMV infection were excluded. Breast milk and infants' urine samples were regularly screened for CMV DNA by fluorescent quantitative polymerase chain reaction. Symptoms and laboratory findings in infants with CMV infection transmitted via breast milk were documented and analyzed. Differences in relevant parameters were analyzed usingChi-square test, Fisher's exact test,t test or Mann-WhitneyU test where appropriately.Results Sixty preterm infants breastfed with CMV DAN-positive milk were recruited. Among them, 19 (31.7%) developed breast milk-acquired CMV infection as their urine samples were positive for CMV DNA, while the others were negative for CMV DNA (infected group:n=19; non-infected group:n=41). The average CMV copies in breast milk, gestational age and birth weight of the infected group were all significantly higher than those of the non-infected group [3.76 (3.18-4.50) vs 3.47 (3.00-4.88) Log10 copies/ml,Z=-2.042;(30.4±2.1) vs (28.4±2.3) weeks,t=3.175; 1290 (750-1500) vs 1110 (575-1480) g,Z=-2.837; all P<0.05). Fewer infants in the infected group than in the non-infected group received blood transfusion [5/19 vs 56.1%(23/41),χ2=4.627,P<0.05]. Ages of the infants with CMV infection ranged from 26 to 164 days (median age of 92 days). Six out of the 19 infants had clinical symptoms concurrent with viral excretion in urine and the ages of these symptomatic infants of infection were earlier than those of the asymptomatic ones without significance [(72±34) vs (97±28) days,t=-1.710,P>0.05]. Four infants (21.1%, 4/19) had severe organ damage and/or positive IgM antibodies to CMV in serum, and were treated with antiviral therapy. Two had mild symptoms and were not given antiviral therapy. All of the six symptomatic infants were followed-up for one to six months, during which time the complete blood cell count and results of biochemical test and fundus examination were back to normal.Conclusions The incidence of breast milk-acquired CMV infection among preterm infants with birth weight≤ 1500 g was 31.7%, and no severe symptoms were reported in this study.

Objective To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for CT-positive mediastinal lymph nodes. Methods From September 2009 to December 2009, 28 patients with confirmed or suspected non-small-cell lung cancer with CT scan demonstrating enlarged ( ≥ 1 cm) mediastinal lymph nodes underwent EBUS-TBNA. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Results 28 patients with 40 lymph nodes were studied. 27 patients had been performed successfully with enough specimens. No complications happened in the group. Mediastinal metastases were confirmed by EBUS-TBNA in 20 patients. 8 patients with benign mediastinal nodes as detected by EBUS-TBNA underwent surgery and mediastinal lymph node dissection, which confirmed N2 disease in 2 patients. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in the detection of mediastinal metastasis were 92.9%, 90.9%,100%, 100%, 75% respectively. Conclusion EBUS-TBNA is a safe and effective technique for CT-positive mediastinal lymph nodes on CT scan.

Medical ethics is an important constitutes of medicine project. The medical ethics of military has its particularity and realism meaning. Combined with the spirit of anti-SARS and the actuality of military medicine ethnics,we must adopt some availability measure to promote the education of military medicine ethnics.