Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Boronic Acids ; administration & dosage ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; therapeutic use

Objective To analyze the etiologies,clinical characteristics and prognostic factors of patients with acute renal failure(ARF)admitted to the hospital at high altitude.Method This retrospective study included clinical data of patients with acute renal failure in the General Hospital of Tibet Military Command from May 2001 to April,2006.Results There were 85 male patients and 63 female patients with mean age(42.4?18.1)years old.Among 148 patients with acquired ARF,52.7% was iatrogenic or nosoeomal origin, demonstrating a trend of increasing.The ARF included pre-renal(n=48,32.4%),renal parenchymal(n= 90,60.8%)and post-renal(n=10,6.8%)in origin.Acute high altitude sickness(n=20)was the major causes of pre-renal ARF.Renal parenchymal ARF could be classified into glomerular vascular lesions(n=24), acute tubular necrosis(n=53),acute interstitial nephritides(n=12),and contusion of unitesticle(n=1).of 90 cases of renal parenchymal ARF,39 patients(43.3%)were induced by medicines.Lithiasis was the major causes of post-renal ARF.The mortality of ARF in our study was 42.6%.The mortality of patients contracted ARF in hospital was much higher than that of patients community ARF in community(55.1 vs 23.6%;P=0.01). There was no significant differences of the mortality between the patients with and without dialysis treatment. Univariate analysis showed that prognosis was correlated with age,the presence of hematuria and oliguria or anuria Hb,and the number of organ system failures.The logistic regression showed that age,Hb and the number of organ system dysfunction were the predictors of mortality.Conlusions The major causes of ARF at high altitude were acute high altitude sickness and the use of medicines with nephrotoxicity.The morbility and mortality of nosocomisl ARF increased significantly.Prevention of MODS is a key management to decrease mortality in severe ARF.

Objective To analyze the present situation of iodine deficiency disorders (IDD) in Henan Province,and to promote implementation of sustainable control strategies.Methods In 2011,a stratified proportion to population probability sampling (PPS) method was used to survey 1200 children aged 8 to 10 in 30 counties of the province.One primary school was selected in each chosen county.Goiter,intelligence quotient (IQ),urinary iodine and salt iodine level were studied.Meanwhile,12 families per capita salt intake was investigated.In each school,30 5th-grade students and 30 pregnant and lactating women in the school townships and adjacent neighboring townships were selected to carry out questionnaire survey on health education with unified papers.Results ①The goiter rate of children aged 8 to 10 by B ultrasound was 4.5％ (54/1201) ; the IQ of 1080 children was 107.75 ± 16.81 ; median urinary iodine level of 358 children was 201.4 μg/L.②The median of salt iodine content was 28.6 mg/kg,the coverage rate of iodized salt was 98.8％ (1186/1200),and qualified rate of iodized salt was 93.0％ (1116/1200).③The residents average daily salt intake was 10.5 g.④Average score of the questionnaire survey of 1084 5th-grade students was 4.2 points.Average score of 961 housewives was 4.4 points.Conclusions Various technical indicators show that IDD is in a sustained elimination state in Henan Province.Strengthen health education,enhance public awareness of disease prevention is still the important work ahead.

Objective To analyze the examination results of external quality assessment(EQA) at all levels of iodine deficiency disorders(IDD) laboratories in Henan province and the network operation to further standardize and improve the laboratory,and to provide reliable laboratory quality assurance for surveillance and control of IDD.Methods The examination results of EQA at all levels of IDD laboratories in Henan province were statistically analyzed in accordance with the National Reference Laboratory (NRL) of IDD (1999-201 1).Results The survey results showed that the provincial level laboratory was all qualified in testing urinary iodine and salt iodine in the past 13 years.In prefectural level,the laboratory response rates were 100.0％,and through participation in EQA,laboratory capacity had been significantly increased and stabilized.From 1999 to 2001,the passing rate of check up of urinary iodine was 22.2％ (4/18),72.2％ (13/18),94.4％ (17/18),respectively,and the rate was stable at 100.0％(18/18) from 2002 to 2011 except 94.4％ (17/18) in 2003.Since 2000,the prefectural level laboratory began to take part in the salt iodine EQA,and the laboratory response rate was 100.0％ (18/18) from 2000 to 2011.Except 88.9％(16/18) in 2003,the passing rate of check up of urinary iodine was 100.0％(18/18)from 2000 to 2011.In 2003 and 2004,6 to 7 county-level laboratories participated in the EQA of urinary iodine in Zhengzhou city,respectively,and all qualified.The number of county-level laboratories that participated in the salt iodine quality control network increased from 29 in 1999 to 148 in 2011.Response rate was 94.4％(68/72),96.7％(58/60) and 92.3％(144/156)in 2003,2006 and 2007,respectively,and the rate remained stable at 100.0％ in the remaining 10 years.In 1999,the passing rate was 69.0％ (20/29),then increased significantly,except 86.7％ (26/30) in 2001 and 84.6％(132/156) in 2007,the rates were all above 90.0％ in other years,especially in 2000 and 2009,the passing rates were both 100.0％.Conclusions The accuracy of test results of external quality controls and the normal operation of the network at all levels of laboratories is closely related to the IDD laboratory conditions and detection techniques.

Objective To ssarch for the relationship between hemoglobulin (Hb),erythrocyte protoporphyrin (EP) and the altitude.Methods The altitudes of Guinan and Maduo county in Qinghai province are respectively 3200m and 4300m. The 122 healthy students aged from 7 to 14 years old were selected, Hb and EP of them were respectively determined by the methods of ferric cyanation and fluorospectrophotometry. The statistical treatment was carry out by t test and matched-pair t test.Results The Hb levels of the healthy children aged from 7 to 14 years old in Guinan and Maduo county are respectively 133 .6?10.1 and 152.8?14.0 g/L (t = 12.31, p＜0.001), the EP levels of them are respectively 320.7 ? 114.9 and 347.8 ? 123.6 ?g/L (t = 1.77, P＞0.05), the value of EP/Hh of them are respectively 2.4 ?0 .9 and 2 .3?0.8 (t = 1.12, p＞0.05). The result of matched-pair t test shows that there are not sexural difFerence for Hb, EP and EP/Hb (P＞0.05).Conclusion Along with the increasing of altitude, the Hb and EP levels of the healthy Children aged from 7 to 14 years old are obviously increased and on sexural difference.

Background About one third of congenital cataract is associated with inheriting factor.The inherited heterogeneity has been found in congenital cataract.To seek the pathogenic gene is essential for the gene therapy. Objective Present study was to map and identify the causal gene for autosomal dominant congenital cataract (ADCC) in a Chinese family. Methods The clinical features of all affected members in this family were examined.Blood samples were collected from eleven family members for genetic linkage analysis.Polymorphic microsatellite markers were selected from the regions which harbor all known loci linked with ADCC.Universal fluorescent-labeled M13 primer was used in linkage analysis.Direct genomic sequencing was used to evaluate the candidate gene for example CRYBB2 gene.This study followed Helsinki Declaration and was proved by Tianjin City Ethic Committee.Written informed consent was obtained from each SUbject before any medical procees. Results The maximum two-point LOD score of 1.20 was obtained for marker D22S315 (θ=0).The LOD score of 0.6 was obtained for marker D16S3068.No mutation in all exons of CRYBB2 gene was found in the family. Conclusion CRYBB2 gene associated with ADCC was excluded from the family.A genome-wide linkage screening should be conducted.Genotyping with microsatellite markers using Universal fluorescent-labeled M13 primer can decrease the cost and obtain the same result.

Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; Chondrosarcoma ; surgery ; Endoscopy ; Enterococcus ; pathogenicity ; Humans ; Male ; Meningitis ; diagnosis ; microbiology ; Middle Aged ; Skull Base ; pathology ; surgery

Objective To analyze the perioperative clinical character of the severe neurological complications in intracranial aneurism treated with stent-assisted coiling(SAC). Methods 203 cases of intracranial aneurysms patients treated by SAC were enrolled retrospectively(ruptured aneurysm group 45 cases and un-ruptured,aneurysm group 158 cases)and the perioperative clinical character of the serious neurological complications(11 cases)was further analyzed. Results The total rate of serious neurological complication was 5. 4%,11 cases of patients with 13 aneurysms got 13 stents. In the ruptured aneurysm group, 5 cases(11. 1%)suffered severe neurological complications,including intraoperative bleeding in one case, postoperative stent-related ischemia in one case,both 2. 2% . Postoperative bleeding 2 cases(4. 4%),and one case of bleeding during anesthesia induced stage(2. 2%). In the unruptured aneurysm group,intraoperative bleeding in three cases,and postoperative stent-related ischemia in three cases,both 1. 9% . No bleeding case during anesthesia induced stage or postoperative period. Although active rescue treatments were performed, 8 patients eventually died,and the total mortality rate was 3. 9% . Conclusion Intracranial aneurysms patients following SAC treatment may suffer from bleeding,ischemia,severe neurological complications, severe disability,and even die. So,we have to strengthen perioperative management.

Objectives To investigate the application modes of indocyanine green (ICG) angiography,digital subtraction angiography (DSA) and methylene blue angiography in the hybrid surgery of cerebral and spinal arteriovenous malformations (AVMs) and to compare the application value of different intraoperative angiographic methods.Methods From July 2013 to December 2015,55 patients treated with hybrid surgery of cerebral and spinal AVMs in Xuanwu Hospital,Capital Medical University were analyzed retrospectively,including 8 patients with cerebral AVM(Spetzler-Martin grade ≥Ⅲ) and 47 with spinal AVM.Their mean age was 33.8±15.6 years.Intraoperative DSA was performed in a hybrid operation room and methylene blue angiography was performed via the feeding artery.ICG angiography was performed in 4 cases in the initial stage as a comparison.Anatomic cure was confirmed by DSA at 3 months after surgery and the results were assessed.Results All 55 patients performed intraoperative DSA,32 underwent methylene blue angiography and 4 performed intraoperative ICG angiography.The frequency of intraoperative DSA was 3.6±1.3 times for each case.After the resection of the first lesion,the residual lesions revealed by DSA accounted for 27.3% (15/55).85.5% (47/55) patients achieved anatomic cure,in which the patients with midbrain AVM (8/8) and spinal AVM 83.0% (39/47) achieved anatomic cure.Three patients were lost to follow up at 1 year after procedure.The median modified Rankin scale (mRS) score of the cerebral AVMs was 2.0 (0.0-3.8).Compared with 3.5 (2.0-4.0) before procedure,there was significant difference (Z=-2.264,P<0.05).The Aminoff score in patients with spinal AVM after procedure was 3.5 (1.0-6.0).Compared with 4.0 (1.0-6.0) before procedure,there was no significant difference (Z=-0.262,P>0.05).The patients with function preservation (function score equal or better than pre-operation) accounted for 88.5% (46/52).Conclusions Intraoperative DSA could precisely localize the nidi and verify the complete resection.Intraoperative methylene blue angiography could selectively reveal the feeding artery supplied nidi in the operative field and identify the angioarchitecture.ICG angiography could reveal the structures of nidi on the surface of the operation area.The intraoperative methylene blue angiography could replace ICG angiography and achieve the treatment target of anatomical cure of the hybrid surgery of the cerebral and spinal cord vascular malformations.

AlM:To investigate the influence of phacoemulsification with different incision on tear film.
METHODS:Tear film was monitored in 152 patients (169 eyes) after phacoemulsification. Patients were divided into two groups according to the type of incision:group A (76 patients, 83 eyes) with a 3. 2mm corneoscleral limbus incision phacoemulsification and group B (76 patients, 86 eyes ) with a sclemtic tunnel incision. Tear break-up time ( BUT ) , cornea fluorescein staining ( CFS ) , lid-parallel conjunctival folds ( LlPCOF) and lid-wiper epitheliopathy ( LWE ) were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17. 0.
RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant (P<0. 05), however, there were no statistically significant at 3, 6mo(P>0. 05). CFS score:There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P<0. 05), however, there were no statistically significant at 3, 6mo (P>0. 05). LlPCOF:There was a large increase in LlPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups (P<0. 05), however, there were no statistically significant at 6mo (P>0. 05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups (P<0. 05), however, there were no statistically significant differences between the two groups at 3, 6mo (P>0. 05).
CONCLUSlON:The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3. 2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.