Objective To understand the total suspended particulates(TSP)in ambient air and their characteristics on metallic elements in Xi an.Methods 96air samples were collected from the industrial area,industry-traffic mixed area,heavy traffic area and control area in Xi an during the heating season and unheating season,2001.The concentra-tions of TSP in ambient air and the contents of Pb,Mn,Cr,Ni,Cd in inorganic extracts of TSP were determined.Re -sults The concentration of TSP in ambient air(0.5865mg /m 3 )during heating season was significantly higher than that(0.3535mg /m 3 )during unheating season(P

Objective:To investigate association between loneliness and depressive episode among rural older people.Methods:A total of 839 rural adults (aged over 60 years) from Liuyang in Hunan were enrolled by using multi-stage cluster sampling method.The Short-form of the UCLA Loneliness Scale,the Social Support Rating Scale,the Life Events Scale for the Elderly,Quality of Life Scale,and the Activity of Daily Living Scale were used to assess loneliness,the social support condition,the stimulating quantity of negative life events,the quality of life,and the abilities of daily life activities,respectively.The Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders questionnaire survey was performed by a face-to-face interview.Results:The prevalence rate of depressive episode among the rural older people was 6.8％.Multivariable analysis showed that the elderly who were with stronger loneliness were the risk factor of depression (OR=1.126,95％CI 1.038 to 1.221).Conclusion:Loneliness is positively associated with an increased risk of depressive episode.

Objective To investigate the side effects of a new supramolecular drug-platinum compound CCP on the cardiovascular system,respiratory system and neuropsychological system of healthy rat.Methods After abdominal anaesthesia with 4.0 ml/kg of 10%chloral hydrate.the rats were injected with10,20,40 ms/ks CCP respectively,and then the life indexes,including blood pressure,heart rate,electrocardiogram,respiratory rate and depth were recorded through single femoral and tracheal intubations and so to non-anaesthesia rats.Glucose injection was chosen as negative control and carboplatin(15 mg/kg)as positive control.Results After venous injection with CCP,glucose injection and carboplatin as the dosages as above respectively,the blood pressures of the tested rats are from(57.8±14.1)mm Hg to(86.2±8.1)mm Hg,heart rates are from(250.9±95.4)times/min to(356.7±47.7)times/min,respiratory rates are from(59.3±17.7)times/min to(95.7±26.0)times/min.No obvious changes of blood pressure,heart rate and respiration were observed after drug injection,t values are(0.02～1.96),(P＞0.05).Once of sporadically ventrieular premature beat was recorded in one rat of CCP and earboplatin groups and it is not dosage-dependent.There is no side effect of 40 ms/ks CCP in neuropsychological system and daily activity of non-anaesthesia rats.Conclusion CCP injection is safe in rat and there is no obvious change observed in the cardiovascular system,respiratory system,neuropsyehological system of healthy rat.

Objective To evaluate the effect of perioperative administration of Ambroxol combined with Ipratropium on elderly lung cancer patients undergoing thoracoscopic surgery.Methods 82 lung cancer patients aged ≥70 years who were scheduled for thoracoscopic lung resection were randomly assigned into 2 groups:the observation group(n=42) and the control group(n=40).Patients in the observation group were treated with 90 mg Ambroxol(mucosolvan) by intravenous drip and Ipratropium(atrovent) by atomizing inhalation,while patients in the control group were treated with an equal volume of 0.9％ sodium chloride solution.Pulmonary function and changes of arterial blood gases at admission,before surgery and 5 days after surgery,incidences of postoperative atelectasis and pulmonary infection,the rate of return to the intensive care unit(ICU),and the length of postoperative hospital stay were compared between the 2 groups.Results Compared with the control group,the percent predicted forced expiratory volume in 1 second (FEV1％),the ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC％),the percent predicted maximum ventilation volume per minute (MVV％),and the arterial oxygen pressure (PaO2) were increased in the observation group before surgery [(87.0±8.2)％ vs.(80.6±7.6) ％,(90.4±6.4)％ vs.(81.4±7.0)％,(87.1±5.6)％ vs.(74.6±6.9) ％,(86.6±6.2) mmHg vs.(81.7±6.9)mmHg,t=2.477,2.588,2.937,3.405,respectively,allP＜0.05].TheFEV1％,FEV1/FVC％,MVV％ and PaO2 were higher in the observation group than in the control group 5 days after treatment [(76.4±9.2) ％ vs.(67.3±10.2) ％,(74.7±9.1) ％ vs.(63.0±11.2) ％,(69.5±9.2)％ vs.(60.1±9.2) ％,(79.5±11.5) mmHg vs.(70.1±11.8) mmHg,t 2.583,2.987,2.778,2.666,respectively,all P＜0.05].The incidences of postoperative atelectasis,pulmonary infection and the length of postoperative hospital stay were lower or less in the observation group than in the controlgroup[7.1％ vs.25.0％,11.90％ vs.32.50％,(8.5±1.8) days vs.(12.1±2.6) days,x2=4.897,5.072,2.351,respectively,all P＜0.05].No significant difference in the rate of return to ICU was found between the two groups(P＞0.05).Conclusions The combination of perioperative Ambroxol and Ipratropium can effectively improve lung function by improving ventilation and gas exchange function,reduce postoperative pulmonary complications and shorten the length of postoperative hospital stay in lung cancer patients aged 70 years and over.

Objective To investigate the application of left transthoracic small incisions in combination with tubular gastrectomy for radical esophageal cancer surgery in elderly patients.Methods Clinical data of 83 patients with carcinoma in the middle or lower third of the esophagus aged ≥ 70 years who had undergone radical surgery at our hospital from January 2012 to September 2014 were collected.Patients were divided into two groups:the tubular gastrectomy group (n=38) which had undergone radical surgery through left transthoracic small incisions in combination with tubular gastrectomy and the stomach group (n =45) which had been treated with esophagectomy through conventional left posterolateral incisions and esophageal reconstruction with the remnant stomach.Clinical outcomes were compared between the two groups.Results Compared with the stomach group,operative blood loss [(204.3±75.4) ml vs.(258.4±80.2) ml,t=2.720,P＜0.05],chest drainage on the first and second postoperative day [(201.7±82.6) ml vs.(320.5±78.1) ml,(150.8±83.0) ml vs.(244.6 ± 81.2) ml,t =3.221 and 3.189,respectively,each P＜0.05],pain scores on the third postoperative day [(3.73 ± 1.02) vs.(0.24 ± 1.15),t =2.858,P ＜ 0.05],incidence of arrhythmia (13.2％ vs.33.3％,x2 =4.585,P＜0.05),pulmonary complications (18.4％ vs.46.7％,x2=7.353,P＜0.05) and incidences of gastroesophageal reflux and gastric emptying disorders (23.7％ vs.55.6％,0.0％ vs 11.1％,x2 =8.654 and 4.493,both P＜0.05) were less or lower in the tubular gastrectomy group.The two groups had no significant difference in operation time,length of hospital stay,anastomotic leakage,anastomotic stenosis or 1-year survival rate (each P ＞0.05).Conclusions Radical surgery with small incisions through the left chest combined with tubular gastrectomy shows highly favorable clinical outcomes in elderly patients with middle or lower esophageal cancer,and can significantly reduce surgical trauma,decrease postoperative complications,improve the quality of life,and help patients recover after surgery.

Objective To explore the association of human leukocyte antigen (HLA) with pregnancy induced hypertension (PIH).Methods We oligotyped HLA-DQA1, -DQB1 locus of 30 Chinese PIH families and 14 control families in Shanghai area by polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO) hybridization method (probes labeled by nonradioactive technique).Results Compared with the control group, the allelic frequency of HLA-DQB1*0502 was significantly higher in PIH couples, and the sharing of HLA-DQA1 increased in PIH couples as well. No difference was found in HLA-DQA1 allelic frequencies or HLA-DQB1 sharing between the two groups. Analysis of neither HLA-DQA1 nor HLA-DQB1 allelic frequencies in PIH patients and PIH mother-and-fetuses showed positive result.Conclusion HLA-DQB1*0502 may be a marker of susceptibility to PIH. DQB1*0502 itself or some gene(s) located in HLA class Ⅱ region and in linkage disequilibrium with 0502 affect maternal T cell immunity during pregnancy. The increase of compatibility in HLA-D region causes the production of blocking antibody to decrease.

Objective: To evaluate the long-term healing rate of transsphincteric anal fistula treated with anal fistula plug procedure and the risk factors affecting the healing of anal fistula. Methods: A retrospective case-control study was conducted to analyze the clinical data of 207 patients with transsphincteric anal fistulas who received anal fistula plug procedure at the Department of General Surgery, Beijing Chaoyang Hospital of Capital Medical University from August 2008 to September 2012. Inclusion criteria: (1) consistent with the diagnosis of transsphincteric anal fistula: the anal fistula passed through the internal and external sphincter; (2) complete data; (3) initial treatment with anal fistula plug procedure. Exclusion criteria: (1) acute rectal or perianal infection or poorly controlled focal infection; (2) recent incision and drainage of perianal abscess or spontaneous rupture of abscess; (3) patients with malignant tumor; (4) patients with Crohn′s disease or ulcerative colitis; (5) patients with heart, liver, brain, lung or renal insufficiency; (6) cachexia due to various chronic wasting diseases; (7) patients could not tolerate surgery. Patients were followed up for anal fistula healing. The cumulative healing rate of patients with transsphincteric anal fistula was plotted using the Kaplan-Meier method, and the factors affecting anal fistula healing were explored by univariate and multivariate logistic regression analysis. Results: There were 186 males and 21 females with age of 15 to 69 (mean 38) years. The duration of anal fistula was 3-60 (mean 15) months. Three patients had a history of previous episodes of perianal abscess and underwent incision and drainage of perianal abscess (all more than 3 months). During follow-up ending on October 31, 2018, 72 patients (34.8%) were lost to follow-up. Among 135 patients who were successfully followed up, the average follow-up period was 96 (75-124) months. Seventy-five patients had anal fistula healing, with healing rate of 55.6%. Kaplan-Meier survival curve showed that the healing time of anal fistula was prolonged and finally stabilized at 55.6%. In the patients who failed initial treatment with anal fistula plug packing, there were 6 cases whose anal fistula healed spontaneously without other treatment. Among them, 3 cases healed spontaneously 2 years and 3 cases 3 years after operation without recurrence. From 2008 to 2012, the annual healing rates of anal fistula plug treatment were 3/6, 61.5% (24/39), 42.1% (24/57), 12/15 and 12/18, respectively. Multivariate logistic regression analysis showed that the duration of anal fistula≥6 months (OR=3.187, 95% CI: 1.361-7.466, P=0.008) was an independent risk factor for anal fistula healing after treatment with anal fistula plug. Conclusion The long-term efficacy of anal fistula plug procedure in the treatment of transsphincteric anal fistula is positive, and this procedure should be implemented as soon as possible.

Humans ; Diabetes Mellitus, Type 2/surgery* ; Gastrectomy ; Gastric Bypass ; Obesity/surgery* ; Obesity, Morbid/surgery* ; Treatment Outcome ; Laparoscopy ; Retrospective Studies

OBJECTIVETo study the clinical and genetic characteristics of Pallister-Killian syndrome and improve the diagnosis for this rare chromosomal disease.

METHODSStandard G-banding was carried out for the patient and his parents. Single nucleotide polymorphism array (SNP array) for copy number detection was applied to identify chromosome microdeletion or microduplication. Interphase fluorescence in situ hybridization (FISH) and cytogenetic analyses of fibroblast cells were performed based on the Results of array.

RESULTSThe patient's G-banded karyotype has turned out to be 46,XY, whilst his parents were both normal. A duplication of the whole short arm of chromosome 12 was detected by SNP array in the child. The result of interphase FISH performed on interphase chromosomes derived from peripheral blood cells was nucish (RP11-104 b5, a19 RP11-956) × 4 [19/100］, whilst the karyotype of fibroblast cells was 47,XY,+i(12) (p10 [44]/46, XY[56].

CONCLUSIONBy combining with clinical characteristics, SNP array, skin fibroblasts karyotype analysis and FISH can diagnose Pallister-Killian syndrome effectively.

Chromosome Banding ; Chromosome Disorders ; diagnosis ; genetics ; Chromosomes, Human, Pair 12 ; genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Polymorphism, Single Nucleotide ; Pregnancy ; Prenatal Diagnosis

Objective:To analysis the clinical characteristics of The clinical characteristics of using automated external defibrillation in the public place,To explore the feasibility and effectiveness of AED application in public places in China.Methods:From January 2014 to April 5, 2019, 54 cases of on-site emergency medical records of AED use in public places in China were analyzed retrospectively from three aspects: patient and AED user attributes, and AED clinical performance.Results:After field application of AED analysis, 54 patients did not have out of hospital cardiac arrest in 9 patients; cardiac arrest in 45 patients, cerebral resuscitation in 40 patients (88.9%), death in 5 patients (11.1%), one of them died in hospital. The accuracy of AED for defibrillation rhythm recognition and defibrillation recommendations was 100%. The success rate of shock to VF was 97.22%, and that of non pulse VT was 100%. The data shows that AEDs of different brands show clinical effectiveness in the core indicators of work. The operation level of the rescuer determines the critical time of AED shock, which is closely related to the prognosis of the patient ( P<0.05) . Conclusions:AED is reliable and effective in electric shock decision and performance.The overall efficiency of AED application can be improved by strengthening training, shortening the critical time of electric shock, rational configuration and effective management.