Exposure to high concentration fluoride could do harm to many systems and organs. Recently,great progress has been mad e on the effect of fluoride exposure on immune function including cell immunity, mucosal immunity and cytokines. The aim of this review is to report it.

OBJECTIVE: Analysis of multislice CT (MSCT) on the misdiagnosis reasons of children bronchial foreign body, avoid missed diagnosis, to achieve reasonable application. METHOD: Fourteen cases of misdiagnosed cases of data were retrospectively analyzed in our department of suspicious in children with bronchial foreign body, and discuss the misdiagnosis reasons. RESULT: Fourteen cases of misdiagnosis of children with 9 cases by MSCT examination showed no obvious foreign matter. Through bronchoscopy intraoperative found foreign body, 5 cases by multislice CT (MSCT) to found foreign body, 4 cases of phlegm scabs, 1 case is inflammatory granulation, all recovered after treatment. Reasons of misdiagnosis were threshold selection error, scanning level from the inception glottis, imaging error, etc. CONCLUSION MSCT is a very valuable diagnostic on airway foreign body check method, but there are certain limitations, we should improve the understanding of misdiagnosis and reduce the occurrence of this phenomenon.
Bronchi ; Child, Preschool ; Diagnostic Errors ; Female ; Foreign Bodies ; diagnostic imaging ; Humans ; Infant ; Male ; Retrospective Studies ; Tomography, Spiral Computed ; methods

Objective To explore the protective effects of peritoneal dialysis on tissue and organ damage induced by acute hemorrhagic necrotic pancreatitis (AHNP) . Methods Thirty-four AHNP patients were randomly divided into PD group ( n = 21) and control group (n=13). Control group was treated with conventional therapy, while PD group was treated with conventional therapy companied by intermittent peritonea] dialysis (IPD). Urinary and serum amylase, the plasma levels of TNF and IL-1, faecal occult blood test and serum leucocyte were examined. Functions of brain, kidney , liver and heart were observed. Results The protective effect was better in PD group than that in normal group (P

BACKGROUND:In recent years, the spinal internal fixation technology has made rapid development based on biomechanics and material sciences.
OBJECTIVE: To review the biomechanical characteristics of the lumbosacral spine and the application of various internal fixation materials in the reconstruction of spinal stability after lumbosacral spinal tuberculosis.
METHODS:A computer-based search of Medline and Chinese Journal Ful-Text Database was performed for relevant articles using the keyword of “lumbosacral spinal tuberculosis, biomaterials materials, fixation” in English and Chinese, respectively.
RESULTS AND CONCLUSION: Rigid internal fixation is a conventional treatment for lumbosacral tuberculosis, which improves the spinal alignment and stability during the spinal reconstruction. Metalic materials such as stainless steel, titanium and titanium aloys have been widely used in rigid internal fixation, but metal sedimentation, non-transparency, stress shielding and osteoporosis after internal fixation impact the fusion effects and imaging observation. Absorbable materials as newly-developing materials have good biocompatibility and biodegradability in orthopedic internal fixation. To select the appropriate material for internal fixation, the biomechanical properties of internal fixation materials wil be investigated according to the degree of vertebral damage and lumbosacral stability.

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) and the efficacy of proton pump inhibitor (PPI) in treating gastroesophageal reflux. Methods Fifty-eight CAPD patients with good clinical and complete dialyzed eondition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire (RDQ). The patients who had RDQ≥6 and <12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment.Results The common symptom was regurgitation (64.70%), followed by acid reflux (52.9 %), non-cardic chest pain (47.1. %) and heart burn (17. 6%). After 4-week treatment, the RDQ was significantly decreased (P< 0. 05). But there was no difference in outcome of treatment between patients with RDQ≥ 12 and RDQ< 12 (P=0. 059). Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.

BACKGROUND: Magnetic resonance imaging(MRI)is considered safe for diagnosis of meniscus injury,having accuracy as high as 80% to 100%.However,it is found that there are some false positive and false negative in the clinic.OBJECTIVE: Through assessment of menisci injuries of the knee using magnetic resonance imaging and arthroscopy,to investigate MRI manifestation in different types of meniscal injuries.METHODS: A study from January 2003 to December 2008 was performed in 212 patients with knee injury undergoing preoperative MRI.Radiograph was read by physicians who had a senior professional title from radiology and orthopaedics departments,and meniscus damage and damage morphology were predicted.Arthroscopy was conducted by chief physician.Meniscus damage during surgery was considered as gold standards.The accuracy of them was compared.The statistics of accuracy of MRI diagnosis was gathered.RESULTS AND CONCLUSION: Totally 212 patients and 230 knees were included,and a total of 215 knees of meniscus injury were described by MRI diagnosis and 213 knees of meniscus injury were proven by arthroscopy.The sensitivity,specificity and accuracy of MRI diagnosis of meniscus injury respectively were 93.5%,64.7%,93.0%.It is found that the sensitivity of MRI diagnosis of bucket-handle damage is high.MRI is easy to miss diagnosis in a light meniscus posterior horn tear,and resuts are more false positive in lateral meniscus injury.It needs arthroscope operation or further surgery in some condition such as gradeⅢ type injury,meniscus displacement after injury and articular capsule separation,which indicates instable meniscus.

Objective To investigate the influencing factors and predictors for radiation encephalic necrosis after CyberKnife radiotherapy.Methods Ninety-four patients (104 targets) with primary or metastatic intracranial tumors who were treated with CyberKnife radiotherapy from 2006 to 2011 were retrospectively analyzed.All surgeries adopted skull tracking modes with a dose of 12-45 Gy in 1-8 fractions prescribed to 60％-87％ isodose line.Radiation encephalic necrosis was determined by imaging or pathological examination.Logistic regression analysis was used to analyze the relationship between radiation encephalic necrosis and factors including diabetes,cardio-cerebrovascular diseases,target volume,isodose line,prescribed dose,number of fractions,combination with whole-brain irradiation (WBI),and biologically equivalent dose (BED).Predictability and critical threshold of all influencing factors for radiation encephalic necrosis were determined by the receiver operating characteristic (ROC) curve.Results Twelve targets (11.54％) had radiation encephalic necrosis.According to the result of logistic regression analysis,BED,combination with WBI,and number of fractions were influencing factors for radiation encephalic necrosis.In the ROC curves,the areas under curves for the above three factors were 0.892 ± 0.034,0.650± 0.072,and 0.712 ± 0.064,respectively,indicating that only BED can well predict radiation encephalic necrosis after CyberKnife radiotherapy with a dose threshold of ＞ 7410 cGy.Conclusions BED,combination with WBI,and number of fractions are influencing factors for radiation encephalic necrosis.BED is the best predictor of radiation encephalic necrosis with a dose threshold of ＞ 7 410 cGy.

Sleep deprivation due to extended work hours and circadian disruptionhas long been a concern in medicine.Clinicians who have been deprived of sleepfailed to ensure that patients are safe or that the quality of care they receive is high.So it can not be ignored to solve the tense relationship between the clinicians and the patients in China.As a result,to pay attention to the fatigue among clinicians and the safety of patients in our country has its practical significance.Take an active strategy to properly resolve the problem of fatigue among clinicians to ensure medical security,the establishment of safe,high-quality health care system,not only directly related to the treatment of patients,but also to the harmonious relations between clinicians and patients to ensure the safety of health care are very important.

Forty-five patients with burn area exceeding 30% TBSA were studied prospectively. Among these 45 patients, 13 developed multiple organ failure (MSOF). Blood superoxide, dismutase (SOD) activity and plasma malondialdehyde (MDA) levels were sequentially determined to assess the role of excessive release of oxygen radicals and lipid peroxidase injury in the mechanism of pathogenesis of postburn MSOF. The results showed that the anti-oxidation capacity of the body was markedly depressed and lipid peroxidase injury markedly increased after a severe burn injury. These changes were not only related to hypovolemic shock after the injury, but also the severity of the burn injury and infection.

This paper explored factors influencing initiatives of clinical teachers in millitary medical university for training clinical undergraduates including work pressure after being transferring to civilian,work pressure,policy orientation,economic pressure,student factor and psychological factor,etc. Meanwhile,this paper explored the incentive mechanism of clinical teachers in millitary medical university for training clinical undergraduates including training and evaluating clinical teach-ing teachers, innovating evaluation criterion and creating sustainable teaching atmosphere (building examples and establishing various incentive systems). All measures taken above was mean to inspire the initiatives of clinical teaching teachers and to ensure the quality of clinical teaching.