Objective To discuss the variety of blood zinc,copper,iron,calcium level in children of lead poisoning Methods The stratified - random sampling method was used. Five hundred and forty children were selected in the urban areas, the rural areas and the islands. We examined blood lead level and other elements levels of these children, and analyzed the changes of these elements levels on condition of lead poisoning. Results The blood zinc level of children with lead poisoning was (4. 93 ? 1 12) mg/L, it was significantly lower than that of children without lead poisoning( t = 2.282 P

Objective To study the clinical feature and original diseases of bone marrow granulomas. Methods A total of 5217 bone marrow biopsies were retrospecitively analyzed in Peking Union Medical College Hospital from January 2001 to December 2007. Results Bone marrow granulomas were present in 20 cases, representing an incidence of 0.38% in the series and an annual incidence of 2. 9 cases per year. Finally, 13 of these cases (65%) were diagnosed with tuberculosis. Hematological neoplasms and viral hepatitis were found in 4 and 2 cases respectively. Acute interstitial nephritis was diagnosed in one case. Conclusions The finding of a granuloma in a bone marrow biopsy is not common and unspecific.Tuberculosis, hematological neoplasms and viral hepatitis are the most common underlying diseases. Bone marrow biopsy is an important method for the diagnosis of disseminated tuberculosis.

Objective To create the effective community-based day-care model of mental disability with multiple approaches. Methods 30 subjects with schizophrenia in Taoranting community in Beijing were selected in control group (n=15) and intervention group (n=15). A day-care multiple rehabilitation model had been implemented in the intervention group. They were evaluated with Positive and Negative Syndrome Scale (PANSS) and WHO Disability Assessment Schedule 2.0 (WHO-DAS 2.0). Results The scores of PANSS negative symp-tom, general psychopathological symptom and WHO-DAS 2.0 significantly reduced continually in the intervention group 8 and 12 weeks af-ter intervention (P<0.01). Conclusion Community-based day-care model can improve the rehabilitation of mental disabled people and inte-grate the community resources for the schizophrenics.

Bone Marrow Transplantation ; Corneal Transplantation ; Heart Transplantation ; Humans ; Kidney Transplantation ; Liver Transplantation ; Lung Transplantation ; Organ Transplantation ; Poisoning ; etiology ; surgery

Objective To explore the diagnostic value of MRI on fetal congenital diaphragmatic hernia(CDH).Methods Fourteen pregnant women with gestation from 16 to 39 weeks were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies.Fast-imaging employing steady-state acquisition(FIESTA),single-shot fast spin echo(SSFSE)and T_1-weighted fast inversion recovery motion insensitive(FIRM)sequences were employed on the axial,coronal and sagittal planes of the fetal brain,thorax and abdomen,especially the thorax.Prenatal US and MR imaging findings were compared with postnatal diagnoses(13 fetuses)or autopsy(1 fetus).US,MR imaging and surgery were used for postnatal evaluation.Results Fourteen pregnant women(12 with a single fetus and 2 with twin fetuses)were studied.There were 12 fetuses(in 2 cases,being one of twins)with a left-sided and 2 with right-sided diaphragmatic hernias.For all cases,the prenatal MRI diagnosis Was correct when compared with postnatal diagnosis or autopsy.Two CDHs were missed and 2 were misdiagnosed by US.Intrathoracic herniated organs in 12 left CDH included the colon(n=1),the stomach(n=1),the bewel(n=5),or both the stomach and bowel(n=5).Intrathoracic herniated organs in 2 right CDH included the bowel(n=1),or the bowel and the right lobe of the liver(n=1).Conclusion Prenatal MRI is effective in the assessment of fetal congenital diaphragmatic hernia.

Objective To explore the diagnostic value of MRI on fetal congenital limb deformities.Methods Sixteen pregnant women,aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women,13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses) ,17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micmmelia (5 cases, 1 of which were twins),bilateral clenched hands (2 cases), right pelydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis.

Objective To explore the diagnostic value of MRI on fetal neural tube defects.Methods Ten pregnant women,aged from 25 to 35 years(average 28 years)and with gestation from 20-39 weeks(average 33 weeks)were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound(US)studies.The imaging protocol included fast-imaging employing steady-state acquisition,single-shot FSE and T_1-weighted fast inversion recovery motion insensitive sequences in the axial,frontal,and sagittal planes relative to the fetal brain,thorax,abdomen,and spines.Prenatal US and MRI findings were compared with postnatal MRI diagnoses(3 fetuses)or autopsy(7 fetuses).Results Ten pregnant women(9 with a single fetus and 1 with twin fetuses)were examined.For all cases,the diagnoses established by MRI were correct when compared with postnatal diagnosis or autopsy.In 7 cases,US and MRI findings were in complete agreement with postnatal diagnoses.US missed the diagnosis in 1 case and misdiagnosed in 2 cases.Ten neural tube defects in this study included anencephaly(1 case),exencephaly (1 case),meningoencephalocele associated with amniotic band sequence(1 case),meningocele(1 case),thoracic myelomeningocele(1 case),lumbar spinal bifida(1 case),sacroiliac myelomeningocele(2 cases),sacroiliac large cystic spinal meningocele(1 case),sacroiliac spinal bifida(1 case).Conclusions Prenatal MRI is effective in the assessment of fetal neural tube defects.It can exactly discriminate herniated contents and locate the spinal lesion level.

AIM:To explore the application effect of pranoprofen combined with tobramycin and dexamethasone ophthalmic suspension in cataract extraction after IOL implantation.METHODS:Retrospective analysis of the clinical data of cataract patients treated from May 2015 to June 2016 in our hospital.According to the treatment methods, patients were divided into tobramycin and dexamethasone ophthalmic suspension with pranoprofen group (combined treatment group) and pranoprofen treatment group.The difference of visual acuity, intraocular pressure, anterior chamber flash change, satisfaction rate and symptom score before and after treatment in two groups were observed.RESULTS:The vision of the two groups before treatment had no difference(P>0.05).At 1wk and 1mo after treatment, the visual acuity of the two groups all improved compared with before treatment, there was no significant difference between the two groups (P>0.05).Before treatment, the anterior chamber flare of the two groups had no difference(P>0.05).At 1wk and 1mo after treatment, the anterior chamber flare of combined treatment group was lower, the difference was statistically different (t=2.435, 1.864;P<0.05).The symptom score of the two groups before treatment had no difference(P>0.05).After treatment, the symptoms and signs of combined treatment group was significantly lower than that of pranoprofen group (t=2.586, 7.820;P<0.05).The satisfaction rate of the combined treatment group patients was 100%, significantly higher than pranoprofen group.CONCLUSION:Pranoprofen and tobradex in the treatment of cataract extraction and intraocular lens implantation has good application effect, can significantly improve the patient's symptoms and signs.

Background Increase of lens thickness at incipient cataract is a key factor of onset of primary angle-closure glaucoma (PACG).Phacoemulsification (Phaco) or phacotrabeculectomy (Phacotrabe) have been documented to be effective for the patients of PACG associated with cataract.However,which surgery is more effective and safe is lack of evidence.Objective This study was to assess and compare the clinical effectiveness of Phaco versus Phacotrabe for PACG with cataract.Methods The relevant literature was searched electronically from the PubMed (1966 to June 2011),EMB Reviews (1966 to June 2011) and Cochrane Library (Issue 1,2011).The manually searching of relevant conference proceedings was used as the supplement.The articles of randomized controlled trial (RCT) about the clinical effectiveness of Phaco versus Phacotrabe for PACG with cataract were included.The methodology quality of included literature was graded.The analysis indexes included intraocular pressure (IOP)-lowing range,postoperative administration of glaucoma drugs,incidence of positive complication,postoperative best corrective visual acuity (BCVA) and perimetry damage.The RevMan4.2 software from Cochrane Collaboration was used for the Meta analyses.Results Three RCTs about phaco versus Phacotrabe for PACG with cataract were selected in this study with the 164 eyes of 164 cases.Meta analysis showed that the IOP-lowing range was larger in the Phacotrabe group compared to only Phaco group with the WMD of 1.17 and 95％ CI of 0.06-2.27 (P =0.040),and the drug dosage of anti-glaucoma was less in the Phacotrabe group in comparison with the Phaco group with the WMD of 0.5 and 95％ CI of 0.24-0.77 (P =0.000).However,the incidence of postoperative complication was higher in the Phacotrabe group than that of the Phaco group with the RR of 0.08 and 95％ CI of 0.02-0.33 (P =0.000).No significant difference was found in the BCVA (WMD =0,95％ CI:-0.13-0.13,P=1.00) andperimetry (WMD =1.01,95％CI:0.56-1.82,P=0.98).Conclusions Compared with Phaco,Phacotrab has a better IOP-lowing effectiveness and slightly worse safety.Phaco and Phacotrab have a fairly influencc in the postoperative BCVA and perimetry.As the sample sizes of the included trials are relatively small,more welldesigned large-scale RCTs are needed.

Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.