Child ; Diabetes Mellitus, Type 1 ; genetics ; Female ; Humans ; Infant ; Male ; Siblings

Objective To observe the changes of hospitalization rates of patients with goiter in Lianyungang City in a coastal area with mild iodine deficiency in 2002-2010.Methods Medical reports of patients with goiter from county hospitals were studied at county level with a retrospective method.In accordance with the National Iodized Salt Monitoring Program,nine townships(towns) were taken from each county (district) [total of five counties(districts)]; four villages were selected from each township (town); salt samples were taken from eight households in each village,and salt iodine was determined using direct titration of sodium thiosulfate.Results The hospitalization rate of patient with goiter increased from 1.87/10 million in 2002 to 7.05/10 million in 2009,and then fluctuated to 6.06/10 million in 2010(x2 =281.91,P＜ 0.01).Among them,female's hospitalization rates were significantly higher than that of male 's(The variation range of x2 values were 35.23-116.04,all P ＜ 0.01),and the hospitalization rates of people over the age of 40 years were significantly higher than that of people less than 40 years of age(The variation range of x2 values were 33.04-263.04,all P ＜ 0.01),and the hospitalization rates of people in urban areas were significantly higher than that of people in rural areas (The variation range of x2 values were 18.35-140.00,all P ＜ 0.01).Average salt iodine was 27.61-30.13 mg/kg in 2002-2010.The coverage rate of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,P ＜ 0.01).There was a positive correlation between hospitalization rate of patient with goiter and coverage rate of iodized salt(spearman correlation coefficient was 0.83,P ＜ 0.05).There was a positive correlation between hospitalization rate of patient with goiter and the consumption rate of qualified iodized salt too (spearman correlation coefficient was 0.93,P ＜ 0.05).Conclusions In Lianyungang City,the hospitalization rate of patient with goiter,the coverage rate of iodized salt and the consumption rate of qualified iodized salt all show upward trend in 2002-2010.The relationship among them is worth further study.

Objective To investigate the injury characteristics and prognostic risk factors of patients with craniocerebral injury so as to provide some suggestions for the improvement of medical prevention,intervention and treatment measures.Methods Trauma database system was applied to collect the medical records of 661 patients with traumatic brain injury admitted to the Department of Neurosurgery of 105th Hospital of Hefei in 2009.Their general conditions,injury characteristics and outcomes were analyzed and the risk factors affecting their outcomes were investigated by Logistic regression analysis.Results Of the patients with craniocerebral injury,the males accounted for 70％ (463/661).The patients at 45 years old or so had the highest incidence of craniocerebral injury.Patient number in the second half of one year was 1.65 times more than that in the first half of one year (412/249 ).Most patients were injured from traffic accidents (87.7％,580/661 ) and 512 patients (77.5％) suffered from multiple injuries.ISS,injury causes,age and injury incidence quarters showed close correlation with the final outcome.Conclusions The patients with craniocerebral injury demonstrates distinctive characteristics in aspects of gender,age,incidence time,injury causes,and multiple injuries,but the ultimate outcomes are related to the injury severity,injury causes,age and other factors.

Objective To learn the control status of iodine deficiency disorders in Baoji City of Shaanxi Province.Methods From 2009 to 2011,according to the National Iodized Salt Monitoring Program,the iodized salt was monitored,and thyroid was examined in 12 counties(areas) of Baoji City.According to rural and urban area stratification,60 children aged 8 to 10 were selected in each county(district),and their urine samples were collected for determination of iodine content.In 2011,per capita daily salt intake was surveyed by the three weighing method at children's home whose urine was collected.Chencang Area,Fufeng County and Taibai County,representatives of Baoji City different geomorphic features were selected for investigation of water iodine,and urinary iodine of pregnant and lactating women,and 15 people were selected in each county (district).Results From 2009-2011,in the 12 counties(areas) in Baoji City,the coverage rate of iodized salt was all 100.00％(3468/3468); the qualified rate of iodized salt and the consumption rate of qualified iodized salt were all ＞ 99.00％.Children's goiter rate was 3.41％(87/2548),3.06％(77/2520) and 3.33％(84/2520),and they were all less than that of the national standard (＜ 5％).Medians of urinary iodine of 8-10 years old children were 368.20,293.80 and 332.50 μg/L,respectively,and the ratios of urine iodine ≥300 μg/L were accounted for 66.42％ (797/1200),48.05％(692/1440) and 56.67％(816/1440),respectively.Median urinary iodine of pregnant women was 301.81 μg/L and lactating women was 329.79 μg/L.A total of 1116 households were investigated,the median of per capita daily salt intake was 8.9 g.Eighteen water samples were collected,range of water iodine value were 0.60-10.25 μg/L.Conclusions Iodine nutrition in general population of Baoji City is exceeded the optimum level,and the current iodized salt concentration has some down space,but fully consideration should be taken on iodine needs in different iodine deficiency areas and among different groups of people.

OBJECTIVE To investigate the correlative factors that would affect the prognosis of geriatric lower respiratory infection.METHODS A total of 101 geriatric patients diagnosed as lower respiratory infection were enrolled in emergency ICU.The laboratory tests such as blood chemical tests,C-reactive protein,and troponin T(cTnT)were obtained twice 2 hours and 24 hours after admission,respectively.Other parameters including general condition,clinical outcomes as well as APACHE Ⅱ and SIRS scores within 24 hours were recorded.RESULTS The ages,cTnT and SIRS score were negatively correlated to clinical outcome.CONCLUSIONS The ages,SIRS scores and cTNT levels are independent prognostic factors in geriatric lower respiratory infection.

Abstract: Objective　To investigate the diagnostic value of joint detection of Mycobacterium tuberculosis rifampicin resistance gene (Xpert MTB/RIF), Mycobacterium tuberculosis ribonucleic acid (TB-RNA) and Mycobacterium tuberculosis deoxyribonucleic acid (TB-DNA) in bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis. Methods A total of 806 patients with suspected smear-negative pulmonary tuberculosis admitted to our hospital from May 2020 to July 2022 were selected, 506 patients diagnosed as bacterial negative pulmonary tuberculosis by clinical, X-ray and sputum samples were classified as bacterial negative pulmonary tuberculosis group, and the other 300 patients with non-tuberculous pulmonary disease were classified as non-tuberculous pulmonary disease group. XpertMTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of all patients were detected. With clinical, X-ray and sputum specimen examination of mycobacterium tuberculosis as the gold standard, the diagnostic efficacy of alveolar lavage solution Xpert MTB/RIF, TB-RNA and TB-DNA alone and in combination was analyzed. Results The positive detection rates of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid of the smear-negative pulmonary tuberculosis group and the non-tuberculosis pulmonary disease group were 69.96% (354/506) and 2.67% (8/300), 61.46% (311/506) and 5.00% (15/300), and 63.64% (322/506) and 8.00% (24/300), respectively. The rates in the smear-negative pulmonary tuberculosis group were higher than those in the non-tuberculosis lung disease group, and the differences were statistically significant (χ2=342.005, 246.930, 235.687, P<0.01). Compared with the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of Xpert MTB/RIF in the diagnosis of smear-negative pulmonary tuberculosis were 69.96%, 97.33%, 80.15%, 97.79% and 65.77%, respectively; those values of TB-RNA were 61.46%, 95.00%, 73.95%, 95.40% and 59.38%, respectively; those values of TB-DNA were 63.64%, 92.00%, 74.19%, 93.06% and 60.00%, respectively; those values of combined diagnosis with Xpert MTB/RIF, TB-RNA and TB-DNA were 61.26%, 100.00%, 75.68%, 100.00% and 60.48%, respectively; the specificity and positive predictive value of combined detection were higher than those of single detection (P<0.05). Conclusions The joint detection of Xpert MTB/RIF, TB-RNA and TB-DNA in bronchoalveolar lavage fluid can improve the diagnostic efficacy of smear-negative pulmonary tuberculosis and is worthy of clinical promotion and application.

ObjectiveTo analysis the clinic outcome(similarities & differences, indication and caution)of repairing fingertip soft tissue defect with two kind of reverse digital artery island flaps with the palmar cutaneous branch of proper digital nerve.MethodsFrom January 2000 to Auguest 2008, all 500cases (514 fingers) were repaired with reverse homodigital artery island flap (263 fingers of 250 cases) and reverse cross finger digital artery island flap(251 fingers of 250 cases).All cases were followed up from 3-8years,compared with flap range,finger extension,sensory rehabilitation,et al. ResultsAll flaps (A & Bgroup) of 500 cases (514 fingers) survived.According to flap range,cross finger flap was better than homodigital flap (P ＜ 0.05); according to finger extension,homodigital flap better than cross finger flap (P ＜0.05); according to sensory rehabilitation,homodigital flap little better than cross finger flap(P ＜ 0.05); according to long-term follow-up, all had no obviously different (P ＞ 0.05).ConclusionHomodigital flap can cover distal soft tissue defect less than 2.0 cm× 2.5 cm, cross finger flap is a better choice for more than 2.0cm×3.0cm of distal soft tissue defect. According to the flap cover area, cross finger flap is first choice,and to finger extension & sensory rehabilitation,homodigital flap is first choice; accoding to finger movements,two kinds of flaps are all good choice.

Objective To learn the existing state of Keshan disease and its trend in Baoji City,and to provide a scientific basis for control of the disease.Methods Feng,Qianyang,Linyou and Long Counties,the Keshan disease affected areas were selected to carry out the case study,and Keshan cases were searched from all registered cases of myocardial patients of the past three years at county-level medical institutions and hospitals of townships(towns).Thirteen villages affected by Keshan disease in Qianyang,Fengxiang,Feng,Linyou and Long Counties were selected as monitoring points to carry out a intensified monitoring.All subjects were surveyed by comprehensive clinical physical examination and 12-lead ECG tracings,and they were diagnosed according to the Keshan disease diagnostic criteria.Ten households were selected randomly in each monitoring point(village),and self-produced wheat samples and adult subject's occipital hair samples were collected for detecting selenium levels.Results Seven hundred and forty-six cardiac cases which containing 17 cases of chronic Keshan disease were discovered in 32 medical institutions,and there were no acute and subacute type of Keshan disease patients.Five thousand seven hundred and twenty-three subjects were examined in the 13 monitoring sites,and 65 cases of Keshan disease were diagnosed which including 17 cases of slow and 48 cases of potential Keshan disease,and no acute or subacute case was found.The total detection rate was 1.14％,and the detection rate ranged from 0 to 2.86％.Hair selenium mean was 0.420 mg/kg; wheat selenium mean was 0.079 mg/kg.Conclusions The Keshan disease detection rate of Baoji City is at a low level.The selenium level of local residents has reached the level of non-endemic area.Constant detection of patient with Keshan disease means various control measures should be reinforced.The comprehensive monitoring program,such as monitoring people's in vivo and in vitro selenium level and others,should be established as soon as possible.

Objective To observe the efficacy ofHuayu Kangyou Formula combined with Western medicine for Hp-related peptic ulcer disease;To discuss the mechanism of action.Methods Totally 152 patients were randomly divided into treatment group and control group, 76 cases in each group. Control group was given standard triple therapy, while treatment group was givenHuayu Kangyou Formula based on the standard triple therapy. The treatment lasted for 6 weeks. The clincal symptom scores and gastroscopy were observed to evaluate the therapeutic effect, adverse reactions were recorded, and relapse of ulcer was followed-up.Results The total effective rates of clinical symptoms in the treatment group and the control group were 94.74% (72/76) and 84.21% (64/76), respectively;the excellent rates were 78.95% (60/76) and 55.26% (42/76), respectively;the incidences of adverse reactions were 5.26% (4/76) and 13.16% (10/76), respectively;the relapse rates after 1 year of follow-up visit were 13.63% (6/44) and 41.67% (10/24), respectively, with statistical significant difference between the two groups (P<0.05).ConclusionHuayu Kangyou Formula combined with Western medicine can effectively improve the efficacy of Hp-relative peptic ulcer disease, reduce adverse reaction rate and relapse rate.

Objective To study investigate the dose accuracy that can be achieved with the method of bulk density assignment.Methods Sixteen cases of nasopharyngeal cancer patients and nineteen cases of esophageal cancer patients who accept radiotherapy in our department were selected.The planning CT images with bulk density assignment to different classes of tissues were applied to calculate the dose distributions,and then the resulting dose volume histograms (DVH) of the tumor and organs of risk were compared with the original treatment plan.The paired t-test was taken for dose comparison between two plans.Results The DVH comparison based on the planning CT and the bulk density assignment CT showed good agreements.With nasopharyngeal cancer patients,differences between the two plans about target and normal tissue were less than 1％.With esophageal cancer patients,the dose differences were less than 2％.Conclusion Preliminary results confirm that the bulk density assignment method can be applied to calculate the dose distributions.