Objective:To assess the changes of selenium nutrition of school-age children in Kashin-Beck disease (KBD) areas of Linzhou County, Lhasa City and Xietongmen County, Shigatse City in Tibet Autonomous Region (referred to as Tibet), and provide a scientific basis for evaluating the effectiveness of prevention and control measures.Methods:According to the historical condition of KBD, a total of 344 children's hair samples were collected to determine the content of selenium in Kazi (KBD area) and Jiangxia townships (non-KBD area) of Linzhou County in 2013 and 2021, Renqinze (KBD area) and Tongmen townships (non-KBD area) of Xietongmen County in 2015 and 2021.Results:Compared to 2013/2015, in 2021, the hair selenium level of children in the four townships increased ( P < 0.001). The selenium nutritional level of more than 90% of the children reached medium or above (hair selenium > 0.25 μg/g) in 2021. The hair selenium levels of girls in the two KBD areas (Kazi and Renqinze townships) were lower than those of boys ( Z = - 2.83, - 2.83, P < 0.05). Conclusions:The selenium nutrition level of school-age children in KBD areas in Linzhou and Xietongmen counties has increased rapidly in recent years. However, the selenium nutrition level of girls is significantly lower than that of boys. It is necessary to strengthen prevention, controlling and monitoring, and to further improve the dietary structure of school-age children through the joint efforts of families and schools, to increase the proportion of exogenous high selenium food intake.

Objective    To investigate the clinical safety and feasibility of thoracic sympathectomy in the treatment of palmar hyperhidrosis based on ambulatory surgery. Methods    A retrospective analysis of 74 patients who underwent thoracoscopic sympathectomy in the Department of Thoracic Surgery of the First People's Hospital of Yunnan Province from January 2017 to April 2021 was performed, including 35 males and 39 females aged 12-38 (21.32±4.13) years. Patients were divided into two groups according to different treatments. There were 34 patients in a control group (adopting traditional surgery), and 40 patients in an observation group (adopting ambulatory surgery). The clinical effects of the two groups were compared. Results    No massive bleeding, conversion to thoracotomy, postoperative pneumo-thorax or severe pneumonia occured in all patients. Univariate analysis of intraoperative indexes showed that the two groups had no statistical difference in total hospitalization cost, operation time, anesthesia time or postoperative waiting time (P>0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group (P<0.05). The time of postoperative out of bed and recovery of walking capacity and the incidence of electrolyte disturbance in the observation group were shorter or lower than those in the control group (P<0.05). There was no statistical difference in white blood count, neutrophils count or postoperative 24 h pulse oxygen saturation fluctuation peak between the two groups (P>0.05). Conclusion    Based on the optimized diagnosis and treatment model, thoraco-scopic sympathectomy with laryngeal mask airway which is performed during ambulatory surgery, is feasible and worth popularizing in thoracic surgery.

Objective    To investigate the feasibility and safety of non-intubation anesthesia in thoracic surgery. Methods    From September 2017 to December 2019, 296 patients were operated at department of thoracic surgery in our hospital. There were 167 males and 129 females with an average age of 50.69±12.95 years, ranging from 16 to 76 years. The patients were divided into two groups according to whether they were intubated: 150 patients were in a non-intubation group, including 83 males and 67 females with an average age of 49.91±13.59 years, ranging from 16 to 76 years, and 146 patients were in an intubation group including 84 males and 62 females with an average age of 51.49±12.26 years, ranging from 16 to 74 years. Intraoperative data, postoperative recovery, inflammatory response of the two groups were compared. Results    There was no statistical difference between the two groups in operation time, blood loss, the lowest oxygen saturation or other indicators (P>0.05). But the highest partial pressure of carbon dioxide of the non-intubation group was higher than that of the intubation group (P=0.012). The non-intubation group was superior to the intubation group in postoperative recovery and inflammatory response (P<0.05). Conclusion    The non-intubation anesthesia is safe and maneuverable in thoracic surgery, and it has some advantages in accelerating postoperative rehabilitation.

Objective To summerize computed tomography (CT) and magnetic resonance imaging (MRI) appearances of the adrenal oncoctyoma(AOC),and to improve the diagnostic accuracy.Methods The 11 cases imaging materials of AOC confirmed by pathology from March 2006 to August 2017 were analyzed retrospectively.There were 3 males and 8 females,aged from 24 to 65 years old(mean 46.8 years).There were 11 cases with CT unenhanced scan in which 9 cases performed enhancing scan,8 cases underwent unenhanced and enhanced MRI scan.Results Of 11 cases (13 lesions),10 cases were singular,1 was unilaterally multiple(3 lesions).5 cases were located in the right side,6 in the left side.10 lesions presented oval,3 were round.The diameters of all lesions ranged from 1.4 to 9.9 cm,with a mean of 3.9 cm.All lesions were shown well-defined soft-tissue density on plain CT scan,69.2％ (9/13) of whom were homogeneous,30.8％ were heterogenous.The CT value ranged from 32.6 to 48.6 HU,with a mean of 37.9 HU.In 9 cases,5 masses were markedly enhanced,2 were slightly enhanced and 2 were moderately enhanced,and all of them depicted prolongedly enhanced on triple-phase scan.The masses of 8 cases appeared isointensity or slightly hypointensity on T1WI,hyperintesity on fat-suppressed T2WI.The signal did not change on opposed-phase imaging.The lesions demonstrated heterogeneously prolonged enhancement to some degree on enhanced TI WI images.There was no peritumoral adjacent invasion,enlarged lymph nodes and metastasis.Conclusions AOC usually presents soft-tissue density on unenhanced CT,no changing on MRI opposed-phase images.The tumors are characterized by markedly heterogeneously prolonged enhanced on enhanced CT and MRI.

Objective To evaluate the clinical value of multi-slice spiral CT (MSCT)in the screening of coronary artery lesions in elderly patients with diabetes mellitus.Methods MSCT and coronary angiography(CAG)were performed in 136 elderly patients(68 patients with diabetes and 68 patients without diabetes).The number of diseased coronary segments and the plaque type (noncalcified,mixed and calcified)for each patient were determined.The characteristics of coronary lesions were compared between patients with and without diabetes.The sensitivity and specificity of MSCT were evaluated.Results More noncalcified and calcified plaques and few ermixed plaques were observed in patients with diabetes,compared with patients without diabetes(noncalcified plagues:10 cases or 14.7％ vs.4 cases or 5.9％;calcified plagues:47 cases or 69.1％ vs.39 cases or 57.4％)(P＜ 0.05).In addition,diabetic patients showed a significantly higher frequency of multivessel disease(P＜0.05).Furthermore,MSCT was able to clearly show stenosis and plaque type in the trunk and branches of the coronary artery,with a sensitivity of 91.0％,a specificity of 95.0％,a positive predictive value of 93％ and a negative predictive value of 96.0％.Conclusions Diabetes is associated with a higher risk of coronary artery disease.MSCT can effectively detect the characteristics of coronary artery disease in diabetic patients and is an effective,noninvasive,and safe screening method.

Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.

Objective To study the imaging appearances of congenital splenorenal venous shunt,and to evaluate their clinical significances.Methods Of 127 283 patients who underwent upper abdominal CT scanning,6 patients were diagnosed to have congenital splenorenal venous shunt.The imagings were studied retrospectively.Plain scanning,enhanced CT and Doppler ultrasonography were performed on all these patients.Results The incidence was about 47/million.The six patients were all females,the age was between 32 to 67 years.The mean age was 48.8 years.Enhanced CT demonstrated that there were twisted and dilated shunting blood vessels between the splenic and renal veins.The diameters in four patients were larger than the splenic and portal veins.In the remaining two patients,they were smaller shunting blood vessels.One patient had an associated absence of right portal vein.Two patients had associated dysplasia of portal veins and splenic veins.MPR,CPR,MIP and VR could three-dimensionally depict the courses,the beginnings and the ends of the splenorenal shunts.Doppler ultrasonography showed counterflow between the portal and splenic veins,and showed the blood in the splenic vein to flow into the left renal vein.Conclusions A congenital splenorenal venous shunt is one of the rare form of congenital extrahepatic portosystemic venous shunts.Enhanced MSCT scan combining with its post-processing techniques could clearly demonstrate the shunt vessels and the associated lesions.Doppler ultrasonography could further demonstrate the shunt direction.

[ ABSTRACT] AIM:To investigate the protective effect of 1, 3-dicyclopentyl-1, 2, 3, 6-tetrahydropyrimidine-4, 5-dicarboxylic acid diethyl ester (ZL-5015) on lethal endotoxin-challenged mice and to explore the underlying mechanism. METHODS:Mouse model of lethal endotoxin challenge and endotoxemia were established by intraperitoneal administration of lipopolysaccharide (LPS) at a dose of 70 mg/kg to the C57BL/6J mice.Mouse peritoneal macrophages stimulated with LPS (10 mg/L) were used as an in vitro inflammatory model.The levels of interleukin-1β( IL-1β) , interleukin-10 ( IL-10) and tumor necrosis factor-α(TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA).Real-time PCR was used to evaluate the mRNA expression of the cytokines.RESULTS:Prophylactic treatment of the mice with ZL-5015 (100 and 200 mg/kg, ig) slightly increased the survival rate, extended the survival time, decreased the serum levels of IL-1βand TNF-α, and increased the serum level of IL-10 in the early stage of endotoxemia as compared with model group.The results of in vitro study demonstrated that treatment of the endotoxin-stimulated mouse peritoneal macrophages with ZL-5015 (10, 20 and 40μmol/L) inhibited the expression of IL-1βand TNF-αat both mRNA and protein levels but promoted the expression of IL-10 at both mRNA and protein levels.CONCLUSION: The tetrahydropyrimidine derivative ZL-5015 shows a moderate anti-endotoxin effect by increasing the survival rate and extending the survival time of the mice challenged by endotoxin, which may result from inhibition of the expression of pro-inflammatory cytokines such as IL-1βand TNF-α, and promotion of the expression of anti-inflammatory cytokine IL-10.

OBJECTIVETo assess the prevalence of depressive symptoms, trends on its longitudinal development and related influencing factors among primary and middle school students in Changfeng county of Anhui province.

METHODSThrough cluster sampling methods, all students from 3 to 9 grades in 5 primary schools and 3 middle schools in Changfeng county of Anhui province were investigated through questionnaire as subjects of baseline survey in December 2009. Subjects of this longitudinal study were students in grades 3, 4 and 7 at the time of the baseline survey and were contacted once a year for two years. At last, a total of 816 students participated in all the three surveys. A structured questionnaire including Children's Depression Inventory, socio-demographic characteristics and some potential influential factors was employed for this study. A Generalized Estimating Equation (GEE) was used to evaluate the related influencing factors of children's depressive symptoms in the longitudinal study.

RESULTSPrevalence rates of depressive symptoms were 11.3% , 10.4% and 8.5% , respectively, at the baseline, 1-year and 2-year follow-up studies, among primary and middle school students. Scores on depressive symptoms of total subjects and children who had always been left at home in the follow-up process showed significant differences at the three surveys (F = 13.423, P < 0.001; F = 5.761, P = 0.003). 25 percent of the 92 students who showed depressive symptoms at the baseline survey remained those depressive symptoms at the 1-year follow-up study and 87 percent of the 23 students who had depressive symptoms at the baseline and 1-year follow-up surveys still showing depressive symptoms at the 2-year follow-up study. Results from the GEE program indicated that grade 3 students, having syblings, family with dysfunction or at low level of self-esteem etc., were prone to development while sex and parents' educational level were not correlated with depressive symptoms.

CONCLUSIONPrevalence of depressive symptoms among primary and middle school students in Changfeng county of Anhui province appeared a decreasing tendency during the follow-up process in our study. Through the longitudinal development, we noticed that the prevalence of depressive symptoms seemed to be related to the personal characteristics, education and family environment of the subjects under our study. Improving the level of family function as well as individual's self-esteem might positively contribute to mental health of those primary and middle school students.

Adolescent ; Child ; China ; epidemiology ; Depression ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Male ; Students ; psychology

Objective To assess the prevalence of depressive symptoms,trends on its longitudinal development and related influencing factors among primary and middle school students in Changfeng county of Anhui province. Methods Through cluster sampling methods,all students from 3 to 9 grades in 5 primary schools and 3 middle schools in Changfeng county of Anhui province were investigated through questionnaire as subjects of baseline survey in December 2009. Subjects of this longitudinal study were students in grades 3,4 and 7 at the time of the baseline survey and were contacted once a year for two years. At last,a total of 816 students participated in all the three surveys. A structured questionnaire including Children’s Depression Inventory,socio-demographic characteristics and some potential influential factors was employed for this study. A Generalized Estimating Equation (GEE) was used to evaluate the related influencing factors of children’s depressive symptoms in the longitudinal study. Results Prevalence rates of depressive symptoms were 11.3%,10.4% and 8.5%,respectively,at the baseline,1-year and 2-year follow-up studies, among primary and middle school students. Scores on depressive symptoms of total subjects and children who had always been left at home in the follow-up process showed significant differences at the three surveys (F=13.423,P<0.001;F=5.761,P=0.003). 25 percent of the 92 students who showed depressive symptoms at the baseline survey remained those depressive symptoms at the 1-year follow-up study and 87 percent of the 23 students who had depressive symptoms at the baseline and 1-year follow-up surveys still showing depressive symptoms at the 2-year follow-up study. Results from the GEE program indicated that grade 3 students,having syblings,family with dysfunction or at low level of self-esteem etc.,were prone to development while sex and parents’ educational level were not correlated with depressive symptoms. Conclusion Prevalence of depressive symptoms among primary and middle school students in Changfeng county of Anhui province appeared a decreasing tendency during the follow-up process in our study. Through the longitudinal development,we noticed that the prevalence of depressive symptoms seemed to be related to the personal characteristics,education and family environment of the subjects under our study. Improving the level of family function as well as individual’s self-esteem might positively contribute to mental health of those primary and middle school students.