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Objective To study the composition and concentration of atmospheric particulate pollutants in four seasons in the industrial and clean living areas， and to provide a scientific basis for the strategy of controlling industrial pollution and atmospheric environment. Methods An industrial area dominated by the automobile industry in Shanghai and a relatively clean living area were selected. Samples were collected simultaneously in both areas and continuously for 7 days in the middle of each season. The composition and concentration of PM2.5 were determined， and the ecological risk of heavy metals in PM2.5 was evaluated by the potential ecological risk index method. Results We found PM2.5 concentration was associated with seasonal changes. The PM2.5 concentration in living areas was the highest in winter， followed by spring， and the lowest in summer. The PM2.5 concentration in industrial areas was the highest in spring， followed by winter， and the lowest in summer. The heavy metals in PM2.5 were the same， including Al， Cr， Mn， Ni， As， Cd， Hg and Pb. The content of Cr， Cd and Pb in PM2.5 in the industrial area is significantly higher than that in the living area. The potential ecological hazard coefficient of PM2.5 heavy metal Cd in the industrial zone was the highest， up to 189.47， and it was the main component of the total potential ecological hazard index of heavy metals. According to the total potential risk grade of heavy metals， the heavy metal Cd in the industrial area had different degrees of ecological harm with seasonal changes. The ecological harm degree of heavy metal Cd was the highest in winter， high in spring and autumn， and low in summer. Conclusion Although the concentration of PM2.5 in the industrial area is not higher than that in the living area， the content of Cr， Cd and Pb in the PM2.5 in the industrial area is significantly higher than that in the living area. The concentration of PM2.5 in the industrial area is mainly related to seasons， industrial production and human factors. The potential ecological harm coefficient of heavy metal Cd in PM2.5 is the highest in comparison with other heavy metals such as Cr， Hg and Pb， and it is the main component of the total potential ecological harm index ofheavy metals.
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Objective To study the composition and concentration of atmospheric particulate pollutants in four seasons in the industrial and clean living areas， and to provide a scientific basis for the strategy of controlling industrial pollution and atmospheric environment. Methods An industrial area dominated by the automobile industry in Shanghai and a relatively clean living area were selected. Samples were collected simultaneously in both areas and continuously for 7 days in the middle of each season. The composition and concentration of PM2.5 were determined， and the ecological risk of heavy metals in PM2.5 was evaluated by the potential ecological risk index method. Results We found PM2.5 concentration was associated with seasonal changes. The PM2.5 concentration in living areas was the highest in winter， followed by spring， and the lowest in summer. The PM2.5 concentration in industrial areas was the highest in spring， followed by winter， and the lowest in summer. The heavy metals in PM2.5 were the same， including Al， Cr， Mn， Ni， As， Cd， Hg and Pb. The content of Cr， Cd and Pb in PM2.5 in the industrial area is significantly higher than that in the living area. The potential ecological hazard coefficient of PM2.5 heavy metal Cd in the industrial zone was the highest， up to 189.47， and it was the main component of the total potential ecological hazard index of heavy metals. According to the total potential risk grade of heavy metals， the heavy metal Cd in the industrial area had different degrees of ecological harm with seasonal changes. The ecological harm degree of heavy metal Cd was the highest in winter， high in spring and autumn， and low in summer. Conclusion Although the concentration of PM2.5 in the industrial area is not higher than that in the living area， the content of Cr， Cd and Pb in the PM2.5 in the industrial area is significantly higher than that in the living area. The concentration of PM2.5 in the industrial area is mainly related to seasons， industrial production and human factors. The potential ecological harm coefficient of heavy metal Cd in PM2.5 is the highest in comparison with other heavy metals such as Cr， Hg and Pb， and it is the main component of the total potential ecological harm index ofheavy metals.
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Objective:To investigate the MRI features of the primary sinonasal malignant melanoma (SMM) and evaluate the signal pattern based on T 1WI and T 2WI, in order to improve the diagnostic accuracy of SMM. Methods:The MRI findings of 63 SMM cases confirmed by pathology from April 2007 to November 2018 at Beijing Tongren Hospital, Capital Medical University were analyzed retrospectively. The signal intensity of malignant melanoma was classified into four types(Ⅰ—Ⅳ) according to the proportion of signal areas of the largest slice of the tumor on T 1WI and T 2WI. The classification criteria according to T 1WI: type Ⅰ, the area of hyperintensity was ≥50%; type Ⅱ, the area of hyperintensity was <50%; type Ⅲ, the tumor did not show hyperintensity, and the area of isointensity was ≥50%; type Ⅳ, the tumor did not have high signal area, and the area of low signal was ≥50%. The classification criteria according to T 2WI: type Ⅰ, the area of low signal in the tumor was ≥50%; type Ⅱ, the area of low signal was <50%; type Ⅲ, the tumor did not contain low signal area, and the area of isointensity was ≥50%; type Ⅳ, the tumor did not have low signal area, and the area of high signal intensity was ≥50%. The proportion of each type was calculated. Results:According to T 1WI, typeⅠwas identified in 27 cases (42.9%, 27/63), typeⅡ in 25 cases (39.7%, 25/63), type Ⅲ in 4 cases (6.3%, 4/63), and type Ⅳ in 7 cases (11.1%, 7/63). According to T 2WI, type Ⅰwas demonstrated in 29 cases (46.0%, 29/63), type Ⅱ in 28 cases (44.4%, 28/63), type Ⅲ in 2 cases (3.3%, 2/63), and type Ⅳ in 4 cases (6.3%, 4/63). There were 16 cases classified as type I based on T 1WI and T 2WI. Conclusions:Typical and atypical SMM can be identified according to signal patterns. The typeⅠsignal pattern of SMM cases on T 1WI and T 2WI is typical and can be easily diagnosed, but the proportion was less than 50%. For atypical SMM, malignant melanoma should be strongly suspected if hyperintense on T 1WI or hypointense on T 2WI is found.
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In rkcknt ekars,with thk continuous progrkss of multidisciplinare comprkhknsivk diagnosis and trkat-mknt tkchnologe,thk outcomks of childhood brain tumor(CBT)havk bkkn significantle improvkd,and most of thk CBT can bk kxpkctkd to achikvk a long-tkrm survival. Howkvkr,duk to thk spkcific naturk and location of thk tumor,as wkll as thk possiblk of trkatmknt-rklatkd damagk,CBT survivors havk mork diskask or trkatmknt rklatkd latk kffkcts. Thkrk-fork,thk rkskarchks on improving thk qualite of lifk for CBT survivors havk bkkn highle conckrnkd in thk intkrnational fikld of diagnosis and trkatmknt for CBT. Bkcausk of a rark of domkstic rkports,thk rklkvant forkign litkraturk in rkcknt ekars,and thk brikfle introduck thk rklkvant intkrnational rkskarch progrkss and stratkgic objkctivks wkrk summarizkd, and in ordkr to with thk progrkss of CBT diagnosis and trkatmknt tkchnologe,carre out rklatkd rkskarch on improving thk qualite of lifk of CBT in our countre.
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OBJECTIVE: To analyze the impact of revised version of GBZ 49-2014 Diagnostic of Occupational Noise-induced Deafness on the diagnosis of occupational noise-induced deafness( ONID). METHODS: A total of 77 patients applied for ONID diagnosis and identification were selected as study subjects by judgment sampling method. The pure tone audiometry data were collected and diagnosed based on the criteria of GBZ 49-2014 and GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness. The changes of the diagnostic audiometry and the ONID diagnostic classification were compared. RESULTS: The monaural threshold of weighted value of the good ear calculated by GBZ 49-2014 was higher than the speech frequency threshold average of the good ear of GBZ 49-2007 [( 32. 4 ± 10. 3) vs( 29. 8 ± 10. 6) dB,P <0. 01]. The binaural high frequency threshold average calculated by GBZ 49-2014 was higher than that of GBZ 49-2007[( 50. 5 ± 13. 3) vs( 49. 1 ± 13. 6) dB,P < 0. 01]. The ONID diagnosis conclusions diagnosed by using GBZ 49-2014 and GBZ 49-2007 were consistent( Kappa value = 0. 92,P < 0. 01). There was statistical difference in the ONID diagnostic classifications diagnosed by using GBZ 49-2014 and GBZ 49-2007( P < 0. 05). Three ONID patients diagnosed as non ONID by GBZ 49-2007 were diagnosed as mild ONID by using GBZ 49-2014,and five cases diagnosed as mild ONID by GBZ 49-2007 were diagnosed as moderate ONID by using GBZ 49-2014. CONCLUSION: The diagnostic audiometry calculated based on GBZ 49-2014 is higher than that based on GBZ 49-2007. The number of ONID patients increased and the diagnostic classification became serious when the diagnosis was made based on GBZ 49-2014.
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Wiskott-Aldrich syndrome (WAS) is due to the mutation of the WAS gene on the X chromosome,which has both features of primary immunodeficiency disease (PID) and congenital hereditary hematopoietic disease.Although the clinical manifestations of classic WAS were more obvious,the related gene (WAS) and its protein product (WASP) have the value of diagnosis,but due to the low incidence,and there were significant differences in the severity of clinical symptoms of the patients,so WAS is easily misdiagnosed.This article through collecting and analyzing the recent years of research progress of literature data and the clinical reports,and combined with the author＇s previous experience in the diagnosis and treatment,to induct the main points of diagnosis and treatment for WAS.
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Objective To investigate the clinical efficacy of drug phonophoresis therapy in the treatment of acute iridocyclitis.Methods According to randomized block design,104 patients with acute iridocyclitis were divided into the control group of 52 cases (72 eyes)with 1％ atropine mydriasis,oral prednisone tablets and subconjunctival injection of dexamethasone treatment,76 eyes of 52 cases in the treatment group with 1％ atropine mydriasis,oral prednisone tablets and dexamethasone phonophoresis intraocular treatment.Results Compared with the control group,the cure rates of treatment group and control group were 84.2％ and 58.5％ respectively,there was significantly significant difference between the two groups(x2 =12.598,P =0.000),oral hormone time from the beginning to the first reduction[treatment group and control group were (5.12 ± 1.00) d and (7.32 ± 0.97) d respectively (t =-13.495,P =0.000)] and oral hormone total time [treatment group and control group were (27.82 ± 4.84) d and (35.49 ± 4.74) d respectively (t =-9.720,P =0.000)] were significantly shortened,complications decreased significantly[conjunctival edema rate (x2 =9.657,P =0.002),subconjunctival hemorrhage rate (x2 =6.601,P =0.010),conjunctival scarring rate (x2 =4.340,P =0.037),pain rate (x2 =63.419,P =0.000) and oculocardiac reflectivity rate (x2 =33.293,P =0.000)] and patient satisfaction improved significantly (treatment group and control group were 94.7％ and 69.4％ respectively) (x2 =16.333;P =0.000).Conclusion Dexamethasone phonophoresis therapy has better clinical efficacy and higher cure rate,and it is non-invasive,safe and reliable,less complications and high satisfaction in the treatment of acute iridocyclitis.
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Objective To improve the early diagnosis of Wiskott-Aldrich syndrome (WAS),through summing up and analyzing the clinical characteristics of children with WAS.Methods The clinical and laboratory characteristics of 18 children with WAS,including the cases from Suzhou Jiulong Hospital,Shanghai Jiaotong University School of Medicine,and Tongji Hospital Affiliated to Tongji University,and the domestic reports in recent 6 years,were induced and analyzed.Results All patients were males;the average of incidence age was about 1.9 months and the average age at diagnosis was 10.8 months.All cases had the clinical characteristics of WAS including eczema,infection tendency and thrombocytopenia with small platelet size.Moreover,10/18 cases (55.56％) WAS patients progressed to severe cases (scores reached to 4 or 5 points)at diagnosis,and with the increase of age of the patients at diagnosis,the ratio of severe cases would be increased.The conventional immune function indexes showed no specific diagnostic value,and the typical clinical features and the WAS gene mutation detection were the key diagnostic basis.Seven cases used to be misdiagnosed as idiopathic thrombocytopenia,and received corticosteroids and intravenous immunoglobulin therapy.In a total of 18 cases,4 cases received allogeneic hematopoietic stem cell transplantation,of which,β cases were cured and 1 case died of transplantation-related interstitial pneumonia,while the remaining 14 cases are unknown for their with follow-up treatment and prognosis.Conclusions The typical clinical features and the WAS gene mutation detection were the key diagnostic basis.In order to improve the rate of early diagnosis and avoid misdiagnosis,it's a great need to improve the clinical understanding of WAS.
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The incidence of children with iron deficiency (ID) and iron deficiency anemia (IDA) is still higher in ourcountry now, but the relevant prevention and treatment still lag behind. This paper provides a brief summary of the importanceand impact of childhood ID and IDA prevention and treatment practice based on the recent literatures andThe recommendationsof prevention and treatment for children with iron deficiency and iron-deficiency anemia recommended by the Pediatric HematologyGroup recently.
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ObjectivesTo summarize the application ofGuidelines for the Management of Community-Acquired Pneu-monia (CAP) (2013 edition) in the diagnosis and treatment of children with CAP.MethodsThe clinical features of 209 children with non-severe CAP at different age stages were retrospectively analyzed. The curative effect of azythromycin was summarized which was used as ifrst-line antibiotics in the CAP treatment.ResultsIn 209 CAP children, the onset of 94 children was occurred in spring and summer and 115 occurred in autumn and winter. The white blood cell counts (WBC) in 51 CAP children (24.4%) were more than 10.0×109/L and absolute neutrophil counts (ANC) in 91 CAP children (43.5%) were more than 5.0×109/L. C-reactive protein levels in 199 CAP children (95.7%) were increased and MP-IgM showed positive in 94 CAP children (45.0%). 173 CAP children (82.8%) presented unilateral inlfammatory lesions in chest X-ray, and the right side was predominant. There was no difference in onset season among different age groups (P>0.05). However, the percentage of WBC≥10×109/L among different age groups were signiifcantly different (P=0.002) and the percentage of WBC≥10×109/L was highest in infants and young children group. The proportion of onset in spring and summer was signiifcantly higher in MP-IgM positive group than that in MP-IgM negative group (P<0.01). The total effective rate of azithromycin used as ifrst-line antibiotics was 98.1% (205/209), and there was no signiifcant difference in total effective rate of azithromycin between MP and non-MP pneumonia groups.Con-clusionsThe Guidelines for the Management of CAP (2013 edition) have a reference value in the diagnosis and treatment of CAP in our region where the CAP in children has some different features.
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Cytosine arabinoside (Ara-C) is one of the key chemotherapy drugs comprising all stages combined protocols during long-term chemotherapy for children with acute leukemias,which demonstrated its efficacy and safety.Along with the progress of basic and clinical researches,in Ara-C clinical dose and treatment,prevention of adverse reactions,relationship between the drug metabolism and long-term clinical results,and new nucleoside drugs have achieved remarkable results.This paper on the above fields of research,progress and trends,briefly summarized as follows.
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Objective To determine the plasma concentration of cytarabine(Ara-C) in children with leukemia and obtain dynamics parameters, and investigate the relationship between the parameters and clinical effect in order to provide the basis for optimization of Ara-C application. Methods Using highperformance liquid chromatogram (HPLC) to determine the plasma concentration of Ara-C, its metabolite Ara-U and infusion rate in 37 children with acute leukemia, their therapeutic reaction, remission, treatment-related infection, side-effect and long-term treatment effect were analyzed in statistic. Results Ara-C by 1～2 g/m2 intravenous drop infusion for 2 hours, the peak plasma concentration time was 2 h and peak concentration were (14.37-84.44)μmol/L, and the median was (41.42±22.80)μmol/L. The median infusion rate was 869.57at 30 minutes after Ara-C drip completion, its average level was (253.40±81.49) μmol/L, over six-times than Ara-C peak concentration. The median continuous complete remission time in 37 children was 29.8 months (5.0～53.1 months), 3y-DFS was (90.63±5.15)%. The therapy-related infection rate was 56.8 %(21/37),including three children (8.1 %) suffered from severe infection, but there was no therapy-related death and no children were off the protocol due to poor tolerance. Conclusion As post-remission treatment, high-dose Ara-C would not cause cumulation in vivo in children with acute leukemia and side-effect were slight. Ara-C could improve the long-term continuous complete remission rate and clinical cure rate for children with leukemia. Therefore, it was worth to apply in clinical.
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Objective To avoid complicated wiring, a ward calling system based on wireless protocol is studied. Methods The system adopted ZigBee protocol, composed of calling console as network coordinator, bed-extensions as terminals and network routers in each ward. Results After initial configuration, the system could ring an alarm and gave the patient's bed number and ward number when patients called. Also it provided the automated network faults detection system. Conclusion The system is characterized with convenient installation, high intelligence and easy expansibility, and accords with the trend of technology.
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Objective To transform the equipment with traditional RS232 interface into that with CAN connection interface.Methods On the CAN main line,node is the station for information receiving and transmission in the network.The intelligent node can establish the work way ID,the address and the baud rate through the programming.It is mainly composed by the singlechip and the programmable CAN correspondence controller.Results The hardware and software were designed.SJA1000 initialization,transmission and receiving subroutines are including in the software design.Conclusion CAN is a kind of excellent field bus with high reliability,low cost and has been applied in many fields.It has already formed the international standard and been viewed as one of the most widely used field buses in future.Lots of traditional equipment with RS232 interface are facing the problem of CAN interface transformation.
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Function experiment is an important part of the basical medical science experiment.With the reform and construction of the function laboratory,a kind of new experiment teaching system is set up to improve laboratory utilization,promote the experiment effect and turn a student into an expert in medical science.
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Since the hospital metrology station is the principal part of military metrology system,its handwrought operation greatly affects the working efficiency and implementation effects.In order to enhance working automatization,some metrology software was developed,but they only focused on the metrology management.This software achieves more functions such as auto-hint,auto-count of the inspection parameters,auto-output of the certification and so on.