Surgical treatment of jugular vein phlebectasia in children.

BACKGROUND: Jugular vein phlebectasia (JVP) is a cervical mass that occurs relatively infrequently and usually presents in children as a soft cystic swelling in the neck during straining. It is liable to be misdiagnosed or managed inappropriately. This report elucidates the clinical presentation, diagnosis, treatment choices, and postoperative complications of JVP, and diagnostic methods and treatment choices are recommended. METHODS: Fifty-one cases of JVP were reviewed (right vein in 38 patients, left in 7 patients, and bilateral in 6 patients). The internal jugular vein was involved the most frequently. The main complaint was a soft and compressible mass in the neck, becoming more prominent with the Valsalva maneuver. All of the children except 2 had an ultrasound or color Doppler flow imaging (CDFI) performed in combination with the Valsalva's breathing test. Surgical intervention was performed in 46 patients and the other 5 patients were followed-up conservatively for 2 to 15 years. RESULTS: Ultrasound or CDFI showed local dilatation of unilateral or bilateral veins in all patients except 2, and confirmed the diagnosis in combination with the Valsalva's breathing test. Surgical intervention included ligation of the involved jugular vein in 32 patients, and longitudinal constriction suture venoplasty plus encapsulation with medical Dacron cloth or PTFE in 14 patients. All of the children who had surgery recovered uneventfully, except 3 patients undergoing ligation of the right internal jugular vein. CONCLUSIONS: The Valsalva maneuver was most important for establishing the diagnosis. Ultrasound or CDFI, or in combination with the Valsalva's breathing test, was the diagnostic procedure of choice to confirm the diagnosis of JVP because of its clarity, safety, and low cost. Surgical intervention was recommended for cosmetic and psychologic purposes. Ligation or excision of the involved jugular vein was very safe, simple, and effective for most patients. However, in cases of lesions of the right and bilateral internal jugular veins, longitudinal constriction suture venoplasty plus encapsulation might be more preferable and safer, and should be recommended. Otherwise, treatment should be conservative (follow-up evaluation).

Combined treatment of hepatoblastoma with transcatheter arterial chemoembolization and surgery.

Hepatoblastoma (HB) frequently presents at an advanced and unresectable stage. Transcatheter arterial chemoembolization (TACE) had been attempted to improve the feasibility of removing the bulky tumor in the authors' hospital and the results were presented here to evaluate the effectiveness and therapeutic role of TACE in the HB infants. Eight patients (6 boys, 2 girls), ranging in age from 2 months to 12 months, had unresectable HB based on clinical manifestation, B-ultrasound (B-US), chest X-ray film, computed tomography (CT), blood chemistry, and serum alpha-fetoprotein (AFP), and were subjected to TACE 1-3 times. On each TACE, Adriamycin (ADR, 20 mg/m2), vincristine (VCR, 1.5 mg/m2), and cisplatin (CDDP, 40 mg/m2) dispersed in 5-10 mL lipiodol were infused into the tumor, and stainless-steel embolization coils were released into the main feeding artery until completely embolized. Then, all the patients were reexamined once a month. Digital subtractive angiography was performed and the therapeutic strategy of further TACE or surgery was individualized in terms of the changes of tumor stain and the newly forming feeding artery. Six children (75%) had a marked response after the first TACE and were judged as being surgically resectable, but one boy died of pneumonia just before the scheduled operation and another boy preferred further TACE. The other 2 patients had only a partial response and required further TACE before the operation. Thus 6 children eventually underwent complete surgical resection and 1 boy achieved successful disappearance of tumor after 3 episodes of TACE alone. Seven children had an excellent recovery and remained tumor-free for 15-49 months. The results indicate that TACE is an effective and useful preoperative therapeutic choice for unresectable hepatoblastoma, and can improve the resectablity of the bulky tumor and the survival rate of HB patients. Multiple TACE could enhance the therapeutic effect and should be considered if indicated.

Expressions of coordinated stimulating molecular programmed death 1 and its ligand 1 in brain glioma and their clinical significances / 肿瘤研究与临床

Objective@#To analyze the expressions of coordinated stimulating molecular programmed death 1(PD-1) and programmed death ligand 1 (PD-L1) in human glioma and their clinical significances.@*Methods@#A total of 70 postoperative paraffin specimens of brain glioma and 35 normal brain tissues in Heji Hospital Affiliated to Changzhi Medical College from January 2013 to December 2017 were collected. The expressions of PD-1 and PD-L1 in 70 glioma tissues and 35 normal brain tissues were detected by immunohistochemical SP method. The relationship between the expressions of PD-1 and PD-L1 and their correlation with the clinicopathological features were analyzed.@*Results@#The positive expression rates of PD-1 and PD-L1 in glioma tissues were 69% (48/70) and 62% (43/70), respectively, which were higher than those in normal brain tissues [29% (10/35), 31% (11/35)], the differences were statistically significant (χ2 values were 15.099 and 8.407, both P < 0.05). The positive expression rates of PD-1 and PD-L 1 in high-grade glioma were 81% (30/37) and 73% (27/37), respectively, which were higher than those in low-grade glioma [55% (18/33) and 49% (16/33)], the differences were statistically significant (χ 2 values were 5.699 and 4.415, both P < 0.05). There was no significant difference in the positive expression rates of PD-1 and PD-L1 among patients with different sex, age and maximum tumor diameter (all P > 0.05). There was a positive correlation between the expressions of PD-1 and PD-L1 proteins in glioma tissues (r= 0.372, P= 0.002).@*Conclusions@#The PD-1 and PD-L1 may become new biological indicators for evaluating the occurrence and development of glioma.

Expressions of coordinated stimulating molecular programmed death 1 and its ligand 1 in brain glioma and their clinical significances / 肿瘤研究与临床

Objective:To analyze the expressions of coordinated stimulating molecular programmed death 1(PD-1) and programmed death ligand 1 (PD-L1) in human glioma and their clinical significances.Methods:A total of 70 postoperative paraffin specimens of brain glioma and 35 normal brain tissues in Heji Hospital Affiliated to Changzhi Medical College from January 2013 to December 2017 were collected. The expressions of PD-1 and PD-L1 in 70 glioma tissues and 35 normal brain tissues were detected by immunohistochemical SP method. The relationship between the expressions of PD-1 and PD-L1 and their correlation with the clinicopathological features were analyzed.Results:The positive expression rates of PD-1 and PD-L1 in glioma tissues were 69% (48/70) and 62% (43/70), respectively, which were higher than those in normal brain tissues [29% (10/35), 31% (11/35)], the differences were statistically significant (χ 2 values were 15.099 and 8.407, both P < 0.05). The positive expression rates of PD-1 and PD-L 1 in high-grade glioma were 81% (30/37) and 73% (27/37), respectively, which were higher than those in low-grade glioma [55% (18/33) and 49% (16/33)], the differences were statistically significant (χ 2 values were 5.699 and 4.415, both P < 0.05). There was no significant difference in the positive expression rates of PD-1 and PD-L1 among patients with different sex, age and maximum tumor diameter (all P > 0.05). There was a positive correlation between the expressions of PD-1 and PD-L1 proteins in glioma tissues ( r= 0.372, P= 0.002). Conclusions:The PD-1 and PD-L1 may become new biological indicators for evaluating the occurrence and development of glioma.

Association between sarcopenia and hepatic encephalopathy and advances in diagnosis and treatment / 临床肝胆病杂志

@# Sarcopenia is a component of malnutrition in patients with liver cirrhosis. Studies have shown that both sarcopenia and hepatic encephalopathy can reduce quality of life and increase the risk of adverse events, including death, in patients with liver cirrhosis. This article reviews the association between sarcopenia and hepatic encephalopathy and the advances in treatment, so as to provide a reliable basis for the treatment of patients with sarcopenia and liver cirrhosis, prevent the development of hepatic encephalopathy, and thereby improve the quality of life and prolong the survival time of patients with liver disease.

Application of three dimensional histological reconstruction technology research testicular descent on mice / 中华实用儿科临床杂志

Objective:To explore the testicular descent process and temporal morphology and position changes of its neighboring tissues and organs in mice with three dimensional (3D) histological reconstruction technique.Methods:Tissue below the kidney plane of male Kunming mice was harvested on gestation days (GD)15, GD17, GD19, postnatal days (PD)3 and PD7.The tissue was then serially sectioned and stained with hematoxylin and eosin (HE). Slices were scanned and saved by the PerkinElmer automatic section analysis system.Afterward, Photoshop software was used for image registration and alignment, and 3D-doctor software was employed for 3D reconstruction and analysis.Results:(1)The epididymis enveloped the testis, and the tail of the epididymis was connected with the gubernaculum, but no direct connection was found between the lower pole of the testis and the gubernaculum.During pregnancy, each part of the epididymis and the vas deferens of mice were piled up into a mass, making it hard to identify the epididymis.The gubernaculum leads to " swelled" . After birth, the epididymis became large, elongated, and morphologi-cally recognizable, and the gubernaculum degenerated into fibrous cords.During the whole process, the volume of gubernaculum was significantly smaller than that of testicle.(2)Testicles on both sides were similar in shape and asymmetrical in position.The left testicle was lower than the right testicle, and descended before the right one.During pregnancy, testicles on both sides descended from the lower pole of the kidney, the left testical stopped at the lower part of the bladder.and the right one stopped at middle part of the bladder.After birth, the left testicle dropped below the neck of the bladder.Finally, the left testicle was lower than the right testicle.(3) The epididymis descend prior to the testicles.Throughout the process, the tail of the epididymis descended before the testicles, and it pulled the whole epididymis down.Testicles entered the scrotum along the descending path of the epididymis.After the complete descent, the tail of the epididymis remained below the testicles.Conclusions:Through observation, the testicular descend process in mice includes the following steps.First, the tail of the epididymis is pulled down to the inner ring by the gubernaculum, and the tail and body of the epididymis expand the inner ring and the inguinal canal through their morphological changes.The epididymis then continues to go down into the scrotum and expands it.Finally, the testicles and the head of the epididymis follow the epididymis body and enter the scrotum through the enlarged inner ring and inguinal canal.

Optimal dose of dexmedetomidine combined with propofol for anesthesia in patients undergoing modified electroconvulsive therapy / 中华麻醉学杂志

Objective:To investigate the optimal dose of dexmedetomidine combined with propofol for anesthesia in patients undergoing modified electroconvulsive therapy (MECT).Methods:One hundred and sixty patients of both sexes, aged 20-60 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective MECT, were allocated into 4 groups ( n=40 each) by a random number table method: different doses of dexmedetomidine combined with propofol group (D 1, D 2 and D 3 groups) and routine anesthesia group (group C). Dexmedetomidine 0.2, 0.4 and 0.6 μg/kg were intravenously injected in D 1, D 2 and D 3 groups, respectively, the equal volume of normal saline was given instead in group C, and propofol 1.0 mg/kg and succinylcholine 0.5 mg/kg were intravenously injected in turn 10 min later.Venous blood samples were collected before giving dexmedetomidine (T 0) and at 1 min after the end of MECT (T 1) for determination of the plasma epinephrine (E) and norepinephrine (NE) concentrations.Propofol consumption, occurrence of cardiovascular events, duration of epilespsy and energy suppression index were recorded. Results:Compared with group C, the plasma E and NE concentrations were significantly decreased at T 4, and the propofol consumption was reduced in D 1, D 2 and D 3 groups ( P<0.05). Compared with group D 2, the plasma E and NE concentrations were significantly increased at T 1 in group D 1 and decreased at T 1 in group D 3 ( P<0.05). The incidence of adverse cardiovascular events was significantly increased in group D 3 than in the other 3 groups ( P<0.05). There was no significant difference in duration of epilespsy or energy suppfession index among the 4 groups( P>0.05). Conclusion:The optimal dose of dexmedetomidine combined with propofol 1.0 mg/kg is 0.4 μg/kg when used for anesthesia in the patients undergoing MECT.

Self-body weight measurement in overweight and obese adults in China, 2013 / 中华流行病学杂志

Objective@#To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors.@*Methods@#A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting.@*Results@#The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement.@*Conclusion@#It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.

A study regarding the control attempts on body weight and related factors among overweight and obese adults in China, 2013 / 中华流行病学杂志

Objective@#To understand the control attempts of body weight and its related factors among overweight and obese adults in China.@*Methods@#Data was from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program, which covered 302 surveillance sites. 179 570 adults, selected through multistage stratified cluster sampling method, were interviewed. Demographic characteristics and weight-control attempts were collected via face-to-face interview. BMI, waist circumstance and blood pressure were individually measured under physical examination. Venous blood samples were obtained and tested for FPG, OGTT-2h, TC, TG, LDL-C and HDL-C. A total of 87 545 overweight and obese patients were included in this study, with the exclusion of 152 patients having the missed critical information. Rates on weight control and attempts were analyzed, using the complex weighting on samples to represent the overall overweight and obese adults in China.@*Results@#The rate of weight-control attempts was 16.3% (95%CI: 14.9%-17.7%). Among all the 12 133 patients who had undergone weight-control measures, the proportions of different attempts were as follows: diet (40.9%, 95%CI: 38.4%-43.3%), combination of diet and physical activity (31.5%, 95%CI: 28.9%-34.0%), physical activity (22.8%, 95%CI: 21.0%-24.6%) and drug control (1.3%, 95%CI: 1.0%-1.7%). Factors as: being female (OR=1.26, 95%CI: 1.15-1.38), at younger age (18-44 years old, OR=1.51, 95%CI: 1.31-1.74), with high education levels (college degree or above, OR=4.52, 95%CI: 3.76-5.43), having high annual income (≥24 000 Yuan, OR=1.94, 95%CI: 1.63-2.30) etc., appeared as favorable factors for taking the measures vs. rural residency (OR=0.63, 95%CI: 0.55- 0.72) as the unfavorable one.@*Conclusion@#The rate of weight-control attempts appeared low among the overweight and obese adults who were affected by factors as age, education and income level. Personalized intervention measures should be carried out for people with different characteristics.

Study on prevalence of physical activity in rural residents in four counties (districts) of Shanxi and Chongqing / 中华流行病学杂志

Objective To investigate the prevalence of physical activity and its influencing factors in rural residents in Shanxi and Chongqing.Methods In four counties (districts) of Shanxi and Chongqing,local residents aged ≥ 18 who lived there for more than one year and had no plan to migrate to other areas in 2 years were surveyed through face to face questionnaire interviews to collect the information about their daily physical activity time,sedentary time,related knowledge and attitude,and others.Results The physical inactivity rate of the residents was 14.9％,and 88.7％ of residents never took daily physical activity.The average sedentary time was (3.91 ± 2.06) hours.The results of multivariate analysis showed that education level,per capita monthly income and activity degree were the factors influencing physical inactivity.Conclusion The proportion of people who never took daily physical activity in the survey area was higher than the average level in rural areas in China,so measures should be taken to improve the overall rate of physical activity.For people who have exercise willingness,but have no practice,and those who have already increased their physical activities,targeted guidance is needed on the basis of strengthened health education.

Study on prevalence of physical activity in rural residents in four counties (districts) of Shanxi and Chongqing / 中华流行病学杂志

Objective: To investigate the prevalence of physical activity and its influencing factors in rural residents in Shanxi and Chongqing. Methods: In four counties (districts) of Shanxi and Chongqing, local residents aged ≥18 who lived there for more than one year and had no plan to migrate to other areas in 2 years were surveyed through face to face questionnaire interviews to collect the information about their daily physical activity time, sedentary time, related knowledge and attitude, and others. Results: The physical inactivity rate of the residents was 14.9%, and 88.7% of residents never took daily physical activity. The average sedentary time was (3.91±2.06) hours. The results of multivariate analysis showed that education level, per capita monthly income and activity degree were the factors influencing physical inactivity. Conclusion: The proportion of people who never took daily physical activity in the survey area was higher than the average level in rural areas in China, so measures should be taken to improve the overall rate of physical activity. For people who have exercise willingness, but have no practice, and those who have already increased their physical activities, targeted guidance is needed on the basis of strengthened health education.

The application progress of PET-MRI new technique / 中国医学装备

Even though multimodal imaging system has already been applied in clinic, the PET-MRI still is a revolutionary progress of medical imaging, and it is a landmark after PET-CT imaging equipment. MRI not only can solve the limitations of CT, but also can provide abundant morphology and function information; at the same time, PET also play important role in the diagnosis of tumor, nervous system diseases and cardiovascular disease; and in the treatment decision, treatment effect evaluation and prognosis evaluation when it is applied in research of physiological and disease state at the levels of molecular activity and metabolism of human body. With the rapid development of science and technology, this article has summarized the imaging technology and clinical application of PET-MRI in recent years.

Analysis of influencing factors of detecting radioactive iodine uptake by using thyroid function instrument / 中国医学装备

The radioactive iodine uptake(RAIU) has great value in determining the 131I treatment dosage of patients suffered from hyperthyroidism and judging thyroid function. Many factors which could interfere the results of RAIU were as follows: instrumental factors, thyroid radioactivity counts measurement, counts of a calibrated standard in a neck phantom and counts of room background, iodinated drugs and food, anti-thyroid medication, among other causes, have shown to induce varying degrees of errors in RAIU measurements. Irregular measurements which may interfere with radioactive iodine uptake are commonly seen in clinical practice, yet its actual influence has not been reported. Optimization, regularization and quality control of the radioiodine uptake measurement are essentials for clinical routine practice to guarantee appropriate values for clinical hyperthyroidism diagnosis and treatment. All the above factors affecting the measurement of thyroid function instrument for radioactive iodine uptake are analyzed and then put forward the corresponding solutions.

Atopic dermatitis in children aged 1-7 years in Shenzhen city: an epidemiological study / 中华皮肤科杂志

Objective To investigate the prevalence of and influencing factors for atopic dermatitis (AD)in children aged 1-7 years in Shenzhen city,and to analyze difference in diagnostic results between two diagnostic criteria.Methods From December 1st 2013 to March 1st 2014,a questionnaire survey and physical examination were conducted to investigate the prevalence of AD in children aged 1-7 years in Shenzhen city.Results A total of 1 504 children were enrolled into this study,including 716 males and 788 females.Based on the clinical diagnosis by experienced dermatologists,the prevalence of AD was 11.84％ (17811 504) in total,11.73％ (84/716) and 11.93％ (94/788) in males and females,respectively,and there was no significant difference in the prevalence of AD between males and females (x2 =0.01,P ＞0.05).Based on the Williams' diagnostic criteria,the prevalence of AD was 3.92％ (59/1 504) in total,and 4.05％ (29/716) and 3.81％ (30/788) in males and females,respectively.Premature birth was a risk factor for the occurrence of AD (x2 =5.43,P ＜ 0.05).Conclusions The prevalence of AD is evidently increased among children aged 1-7 years in Shenzhen city,and premature birth is a risk factor for AD.Missed diagnosis will be reduced based on clinical diagnosis by experienced dermatologists.

Survey on burden of disease attributable to low fruit intake among Chinese people aged 15 years old and above between 1990 and 2013 / 中华预防医学杂志

Objective@#To analyze the burden of disease attributable to low fruit intake among Chinese population aged ≥15 years old between 1990 and 2013.@*Methods@#We used data from the 2013 Global Burden of Disease Burden of Disease Study to study the situation in China. The population attributable fraction was calculated to estimate and compare the death and disability-adjusted life years (DALY) attributed to low fruit intake between 1990 and 2013 in China (excluded Taiwan, China). An average world population age structure of the period 2000-2025 was adopted to calculate age-standardized rates.@*Results@#Deaths attributable to low fruit intake accounted for 11.02% of all death in 2013, which were higher than it in 1990 (10.38%). In 2013, the number of deaths attributed to low fruit intake in China increased to 1 046 500 from 793 800 in 1990. From 1990-2013, the age-standardized death rate attributable to low fruit intake decreased from 113.04/100 000 to 79.80/100 000. DALYs caused by low fruit intake increased from 18.346 5 million in 1990 to 21.296 7 million in 2013. Compared with 1990, the age-standardized DALY rate attributed to low fruit intake decreased by 34.67%. In 2013, the top three provinces with the highest burden of disease attributed to low fruits intake were Tibet, Guizhou and Xinjiang provinces, with standardized DALY rate at 2 612.53/100 000, 2 281.85/100 000 and 2 198.22/100 000, respectively. Compared with the results in 1990, the standardized DALY attributed to low fruits intake decreased, especially in Tianjin, where decreased by 63.61%; followed by Aomen, Zhejiang, Shanghai and Beijing, where decreased by 59.74%, 59.53%, 56.64% and 53.88%, respectively.@*Conclusion@#Compared with the situation in 1990, the burden of disease attributable to low fruit intake decreased in 2013, but the situation is still serious, especially in Tibet, Guizhou and Xinjiang provinces, where the burden decreased comparatively slowly.

Audiological Outcomes of Sophonotron Bone Conduction Hearing Aid from a Multicenter Investigation / 听力学及言语疾病杂志

Objective The aim of the study was to evaluate the hearing performance of a new transcutaneous bone conduction hearing aid.Methods One hundred and nine patients with conductive or mix hearing loss and eleven patients with single sided sensorineural hearing loss from four tertiary referral centers were tested under unaided and aided conditions with the sound processors on testbands.Free field test was performed to obtain the hearing thresholds and speech recognition thresholds in quiet.Adverse events were also documented by a self-reported questionnaire.Results ①Conductive or mixed hearing loss patients:for aged≥6 yrs subgroup,the bone conduction PTA average of aided sides was 18.55±8.99 dB HL.For aged<6 yrs subgroup, the bone conduction ABR hearing threshold average was 18.33±8.36 dB HL.②Statistically significant improvements in free field hearing thresholds were seen when compared aided hearing with unaided outcomes.The average PTA (pure tone average in free field) was measured at 32.21±10.00, 37.33±14.15, and 34.38±10.76 dB HL respectively in conductive or mixed hearing loss aged≥6 yrs subgroup;aged<6 yrs subgroup and SSD subgroup.③In aided situations;speech recognition thresholds in quiet were significantly better compared to unaided situation in patients aged≥6yrs.④None of patients presented adverse events related to the devices.Conclusion The Sophono bone conduction hearing aid has satisfactory hearing performance and can be considered an alternative device for patients with conductive or mix hearing loss or with SSD.

Domain-specific physical activity among professionals with different occupational activity patterns / 中华健康管理学杂志

Objective To explore the profiles of physical activity domains among professionals with different occupational activity patterns.Methods A cluster random sampling method was used to recruit employed adults aged 30-60 years in Beijing as well as Zhejiang province.The information on the physical activity domains was collected with a revised Global Physical Activity Questionnaire (GPAQ).Results Of 3 326 professionals,about 30.79％,50.75％ and 18.46％ adults had Class Ⅰ (mostly sedentary reading or writing during work time) ,Class Ⅱ (mostly working with arms or legs with little effort) ,and Class Ⅲ (working with effort)occupational activity patterns,respectively.The median volume of leisure time activity and bicycling were all 0 Met-min/week,and no significant difference of domestic activity volume was detected among all the three classes of professionals.Of all the non-occupational activity volume among three classes of adults,domestic activity accounted for the most proportion (58.87％) performed by adults of Class Ⅱ,traffic activity accounted for the most proportion (34.2％) by those of Class Ⅲ,and leisure time activity accounted for the most proportion (12.7％) by those of Class Ⅰ.Most time was spent in sedentary behaviors by those of Class Ⅰ after hours.Conclusions Besides the generally low level of moderate activity,the diversity of the domains of physical activity among this population was evident.It is necessary to develop appropriate technology to improve physical activity for professionals with different occupational activity patterns.

Clinical significance of serum C-C chemokine ligand 19 levels in patients with rheu-matoid arthritis / 北京大学学报(医学版)

Objective:To investigate the serum level of C-C chemokine ligand 19 (CCL19)and its clinical significance in rheumatoid arthritis.Methods:The serum CCL19 levels in both rheumatoid ar-thritis (RA)patients and health controls were detected by ELISA.The proportion of peripheral blood B cells and memory B cell subsets were also detected in some patients.Then the clinical and laboratory data of the patients were collected.The CCL19 levels in patients with different clinical features were analyzed. And the correlation between the clinical data,laboratory parameters,B cell subsets proportion and serum CCL19 levels were also analyzed.Independent samples t test,paired t test,Pearson and Spearman corre-lation were used for statistical analysis.Results:The levels of CCL19 was higher in the RA patients than the health controls (P 0.05).The levels of CCL19 were higher in the serum positive (RF and anti-CCP antibody)patients,but there were no differences between low and high disease activity RA,as well as early and non-early RA. There was no correlation between the serum CCL19 levels and the proportion of B cells as well as memory B subsets.All the proportion of peripheral blood CD27 + memory B cell subsets in RA was lower than the healthy controls,including CD27 +IgD +,CD27 +IgD - and CD27 + B cells.Conclusion:The increased serum CCL19 levels in RA patients are associated with the activity of B cells,so CCL19 might predict whether the RA type is a B cell mediated RA,and specify the treatment directions for the rheumatologist.

Imaging manifestation of metastatic tumors in nasal cavity and paranasal sinuses / 中华放射学杂志

Objective To investigate the imaging manifestations of metastasis in the nasal cavity and paranasal sinuses. Methods Twelve lesions of 10 patients with pathologically proved metastasis were retrospectively reviewed, including 6 renal clear cell carcinoma, 2 pulmonary adenocarcinoma, 1 colorectal carcinoma and 1 hepatic carcinoma. All the patients underwent CT and MRI scan.Among them,9 patients had contrast enhanced MRI scan and 5 patients had dynamic contrast-enhenced MRI as well. The location, bone changes, shape,margin,density,signal intensity, and enhancement characteristics of the lesions were observed. Results The metastasis involved spheno-ethmoid area(n=3), ethmoid sinus (n=2), maxillary sinus (n=2), nasal cavity(n=2), fronto-ethmoid area(n=2) and sphenoid sinus (n=1). All 12 metastatic lesions demonstrated bone destruction with tumor bone formation in 1 lesion. The CT displayed 10 metastases showed equal density, one mixed density was high, another form of low-density mixed. MR imaging showed equal signal in 9 lesions, while low-mixed signal in 3 lesions on T1WI compared with grey matter were found. On T2WI, 11 lesions showed high mixed signal and homogeneous low signal in 1 lesion. All 12 lesions demonstrated markedly heterogenous enhancement after intravenous administration of contrast media. Of 5 cases with dynamic contrast-enhanced MRI scanning, 4 lesions demonstrated wash-out time-signal intensity curve (TIC) pattern and 1 lesion demonstrated plateau pattern. Conclusions Renal carcinoma is the most common primary tumor for nasal cavity and paranasal sinuses metastasis. A typical imaging finding is located in the ethmoid sinuses, the soft tissue mass surrounded with rich blood supply multiple sinuses and significant bone destruction.

Survey and analysis on medical expenses of inpatients in Haikou city / 重庆医学

Objective To understand the basic situation and the influencing factors of medical expenses of the inpatients in Haikou city for the government to developing a scientific control policy of medical expense or improving the existing measures for controlling the medical expense.Methods Totally 463 inpatients from 10 hospitals were conducted the questionnaire survey and the survey data were analyzed.Results The difference of medical costs constituent existed in different medical institutions and the me-dian of drug costs to the total medical costs in general hospital was 42.13%.30.02% (139/463)of the surveyed inpatients thought that the use of “new techniques,new drugs and new equipments”was the primary cause of medical costs rising.51.19%(237/463) of patients thought that the primary considered factor is “cure”when seeing a doctor.24.84%(115/463)of patients did not known the modification of medical insurance policy.46.00%(213/463)and 28.51%(132/463)of patients thought that the main responsi-bility main body for controlling the medical costs rising is government and hospital respectively.Conclusion Increasing the medical insurance policy advocacy,promoting the reform of medical insurance payment methods,strengthening the dominant position of gov-ernment control medical costs and rationally allocating the medical resources conduce to reduce the medical costs rising.