Objective To determine the nature of enlarged mediastinal lymph nodes,the study of CT-guided transbronchial needle aspiration biopsy(CT-TBNA) was conducted. Methods According to classification and locating standard of mediastinal lymph nodes,CT-TBNA was performed in 158 mediastinal lymph nodes of 73 patients,including 54 primary lung cancer with enlarged mediastinal lymph nodes,5 malignant lymphoma, 3 mediastinal abscess and 11 mediastinal inflammatory adenopathy. Results CT confirmed that the needles were inside all 158 lymph nodes. Adequate aspirates for histologic and/or cytologic diagnosis were obtained in 136 of 158 (86%) lymph node biopsies. No serious complications occurred. Conclusion Locating standard of CT-guided TBNA was reliable. Puncture was safe and cost-effective.CT-TBNA was important for ascertaining the nature of mediastinal adenopathy and staging of neoplasms.

Objective To evaluate the efficacy of dexmedetomidine used to supplement lumbar plexus combined with sciatic nerve block for total hip arthroplasty in the elderly patients.Methods Fifty ASA Ⅱ or Ⅲ patients,aged 80-93 yr,with a body mass index of 17-25 kg/m2,scheduled for unilateral total hip arthroplasty,were randomly divided into 2 groups (n =25 each):normal saline group (group NS) and dexmedetomidine group (group D).Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups.After a loading dose of dexmedetomidine 0.5 μg/kg was infused over 10 min starting from 20 min after the block,dexmedetomidine was infused at 0.2 μg· kg-1 · h-1 until the end of surgery.While the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol 20 mg or ketamine 10 mg was infused intravenously when the efficacy of the block was inadequate.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory rate (RR),side effects during operation,requirement for propofol or ketamine and doctor' s satisfaction were recorded after admission to the operating room,immediately after iv administration,at 0,10 and 30 min after the beginning of surgery,and at the end of surgery (T0-5).Results Compared with the baseline value at T0,MAP and HR were significantly increased at T2-5 in group C (P ＜ 0.05),and no significant change was found in the hemodynamic parameters at each time point in group D (P ＞ 0.05).Compared with group C,the MAP,HR,incidences of respiratory depression and agitation and requirement for propofol or ketamine were significantly decreased,and the doctor's satisfaction was significantly increased (P ＜ 0.05).Conclusion Dexmedetomidine can increase the efficacy of lumbar plexus combined with sciatic nerve block when used for supplementation of total hip arthroplasty in the elderly patients,the hemodynamics is stable and side effects are fewer.

Objective:To search for carrier of short active peptide with binding to human CD59 of the surface of HeLa cell.Methods:Ph. D. 12 display peptide library was biopanning with HeLa cell high-expressing CD59. After competitive test, positive phage clones were identified by sandwich ELISA and sequenced.Results:10 phage clones were identified to have higher combination with CD59.Conclusion:The sequence of peptide with binding to CD59 has been obtained.That might lay a basis for design of short peptide of CD59 on tumor sneaking through.

0.05).[Conclusion]The factors causing reductions should be removed arthroscopically.Arthrocopy may be a useful micro-treatment method for DDH.

Objective To approach the efficacy and safety of arotinolol in treating essential hypertension.Methods The studies about arotinolol in treating essential hypertension were accessed by searching the Cochrane Central Register of Controlled Trials(Issue 3,2008),MEDLINE(1991 to March 2009),EMbase(1991 to March 2009),CBMdisc(1991 to March 2009),and CNKI(1994 to March 2009).The relevant journals and conference proceedings also hand searched.Randomized controlled trials(RCTs) in which arotinolol was used to treat patients with essential hypertension were collected.Then the retrieved studies according to predefined inclusion and exclusion criteria were screened,the quality of included studies was evaluated,and Meta analysis was performed by using RevMan 4.2 software.Results A total of 176 articles were found and 6 of which were finally included.In homogeneity test:?2=4.41,df=7,P=0.73(efficacy);?2=2.96,df=4,P=0.56(safety).In combined test,Z=0.64(P=0.52),OR=1.17,OR95%CI(0.72-1.85)(efficacy);Z=1.75(P=0.08),OR=0.60,OR95%CI(0.34-1.06)(safety).Conclusion There is no significant difference in efficacy and safety between arotinolol and control group in treating essential hypertension.

Objective To evaluate the MR cholangiopancreatography (MRCP) diagnosis for cholangitis caused by clonorchis sinensis. Methods Fifty-four cases with cholangitis caused by clonorchis sinensis were examined by MRCP (3D FASE-Heavy T 2WI sequence). The results of MRCP were compared with that of ERCP, laparoscopy, and pathology. Results The diagnostic accuracy for the cause of the disease was 88.9%. Main findings on MRCP included slight dilation of the intra-hepatic biliary duct ( n =46), small cystiform dilation of peripheral biliary ending ( n =43), extra-hepatic biliary dilations ( n =15) and strictures ( n =19), and low signal intensity filling defect in the common bile duct and gallbladder ( n =6). Conclusion MRCP of biliary tree images can be obtained with 3D FASE Heavy T 2WI sequence in considerable details. The characteristic of the cholangitis caused by clonorchis sinensis on MRCP was the slight dilation or stricture of extensive intra-hepatic biliary duct, combined with small cystiform dilation of peripheral biliary ending. MRCP was an ideal technique in diagnosing the disease.

Background and purpose:Breast cancer can be divided into several molecular subtypes according to its biomarkers. The pattern of distant metastasis has a great clinic significance but was rarely investigated. This study investigated the impact of molecular subtype of breast cancer on initial sites of metastasis..Methods:All the patients with operable invasive breast cancer diagnosed in Zhongshan People’s Hospital between 1998 and 2004 were recruited. Subtypes were defined as Luminal A, Luminal B, human epidermal growth factor receptor 2 (HER-2) enriched, and triple negative (TN) according to the expression of estrogen receptor (ER), progestogen receptor (PR) and HER-2 status. The first distant metastatic sites and the time of their appearances were recorded. Survival curves were constructed using the Ka-plan-Meier technique.Results:Among 390 eligible patients, there were 215(55.1%) with Luminal A, 43 (11.0%) with Lu-minal B, 52 (13.3%) with HER-2 enriched, and 80 (20.5%) with TN. The median follow-up time was 118 months (11-163 months). Seventy-two (18.5%) distant metastases occurred during follow-up: 37 metastases in Luminal A, 8 in Luminal B, 10 in HER-2, 17 in TN. Bone was the most common site of the first distant metastasis (39/72, 54.2%) followed by lung (25/72, 34.7%), liver (22/72, 30.6%), and brain (7/72, 9.7%). Among all the metastases, tumors of Luminal type (Luminal A 70.2%, Luminal B 50.0%) had a higher chance of bone involvement than that of HER-2 enriched (30.0%) and TN (35.3%,P=0.03). Both Luminal B (37.5%) and TN (17.6%) subtypes had a higher percentage of brain involvement than Luminal A and HER-2 enriched (P=0.01). The survival analysis showed no significant difference among the four subtypes in 9-year distant metastasis-free survival. However, distant metastasis appeared earlier in HER-2 enriched and TN breast cancer than in Luminal type.Conclusion:Organ-specific metastasis may depend on the molecular subtype of breast cancer. Bone metastasis occurs more in luminal type than in other types. Luminal B and TN types of tumors had more chance of brain metastasis than Luminal A and HER-2 enriched type of tumors.

BACKGROUND: Cephalocervical cancer is closely related with genetic factors, but do the first-degree relatives have a higher risk for cancers? Slenderstyle acanthopanax root-bark has an anti-mutation chromosome stabilizer, can it enhance the anticaner ability of the first-degree relatives? OBJECTIVE: To study the genetic factor of cephalocervical cancer and antimutagenic effect of slenderstyle acanthopanax root-bark.DESIGN:A controlled experiment with human peripheral blood as the sample.SETTING: The Department of Medical Genetics of the Basic Medical Science School, and the Department of Otolaryngology of the First Hospital of Jilin University; The University of Warwick, UK.PARTICIPANTS: The subjects were taken during the period of October 2001 to March 2002. The patients with cephalocervical tumor and their first-degree relatives were all from the Department of Otolaryngology,FirstHospital of Jilin University, and healthy group were well-being blood devoting volunteers from Changchun City Central Blood Bank. There were group( n = 50) included 25 males and 25 females who were healthy blood patients group( n =30) were composed of 22 males and 8 females who did first-degree relative group(n=30) consisted of 19 males and 11 females. They were the first-degree relatives of patients with carcinoma of larynx and carcinoma of nasopharynx. Except for the family history of cancer,they themselves were all healthy. Informed consents were obtained from all of them.METHODS: The peripheral blood was collected as the sample and the lymphocyte culturing was performed. The culture cycle was 72 hours and bleomycin(BLM) (15 mL) was added into it at the 67~ hour, also the slenderstyle acanthopanax root-bark(SARB) (800 mg/L) was added into the antimutagenesis experiment. The cells were collected after culturing for another 72 hours. The conventional method was used for slide preparation. The slides were stained with Giemsa solution without banding. Choosing the proper objective and observing the numbers of chromatid breaks. The numbers of chromatid breaks were converted into the numbers of chromatid breaks per cell (b/c value). Namely, b/c value equals to the quotient, the number of chromatid break divided by the number of the cell observed in the slide.MAIN OUTCOME MEASURES: The number of chromatid breaks per cell (b/c value).RESULTS: All the 110 cases in the 3 groups entered the stage of result It was lower in the control group than that in the patients group and first-degree relatives group(0.16 ± 0.06, 0.48 ± 0. 14, 0.42 ± 0. 12, P ＜0.01). There was no significant difference in b/c value between the paparison between b/c value induced by combined SARB with BLM and only BLM was performed: The b/c value of former is significantly lower than the latter (0.48±0.14,0.15 ±0.08,0.42±0.12, 0.17±0.11,P ＜ 0.01).CONCLUSION: The first-degree relatives of the patients with cephalocervical cancers should be classified as tumor high-risk group. SARB as a chromatid stabilizer has an obvious inhibitory effect on b/c value of the patients induced by BLM and that of the first-degree relatives.

Objective To guarantee the quality of measurenents with the radon-thoron discriminative detectors of our laboratory.Methods LD-P radon-thoron discriminative detector participated in the international intercomparison for integrating radon/thoron detectors organized by National Institute of Radiological Science (NIRS,Japan).Detectors were sent to NIRS for exposure.Radon intercomparison was conducted with radon chamber providing three levels of exposure:low,medium and high levels.Thoron intercomparison was carried out at thoron chamber,which also provided three levels of exposure:low,medium and high levels.Detectors were posted back to our laboratory for etching and analysis after exposure.Then the measured values were submitted to NIRS.Finally the reference values were informed of us.Results The relative percent difference (RPD) between the measured value and the reference value for radon was-13.8％,-14.4％ and-17.1％ at low,medium and high levels respectively,and that of thoron were-14.4％,8.9％ and-3.2％ at three levels respectively.Conclusions Both radon and thoron measurement of our detectors rank asCategory Ⅰ in the 4th international intercomparisons for integrating radon/thoron detectors with the NIRS radon/thoron chambers.

Objective To investigate the expression of Bmi-1,Mdm2 and Ki-67 in extrahepatic biliary duct carcinoma and to evaluate their clinical significance. Methods The expression of Bmi-1.Mdm2 and Ki-67 was detected in 10 normal extrahepatic biliary duct tissue and 30 cases of extrahepatic billary duct carcinoma with immunohistochemic0al staining and the their clinical significance were analyzed. Results No POsitlVe Bmi-1 expression was found in 10 normal extrahepatie biliary duct cages, while 18 of 30 extrahepatic biliary duct carcinoma cases showed positive Bim-1 expression.The expression of Bmi-I in extrahepatic biliary duct carcinoma(60.0%)was statistically higher than that in normal extrahepatie biliary duct(P<0.05).The positive expression rate of Mdm2 in extrahepatic biliary duct carcinoma was significantly higher than that in normal extrahepatic biliary duct (56.7%vs 20.0%,P<0.05).The cases of extrahepatic biliary duct carcinoma with Ki-67 proliferation index higher than 5%reached 60.0%,while the Ki-67 index was all lower than 1%in 10 normal extrahepatic biliary duct tissue, suggesting the higher proliferating activity of extrahepatic biliary duct carcinoma.No differences were found in the expressions of Bmi-1,Mdm2 and Ki-67 among extrahepatic biliary duct carcinoma cases with different clinical pathological features. Conclusion The results indicate that the expression of Bmi-1 and Mdm2 up-regulation may play an important role in carcinogenesis of extrahepatic biliary duct caroinoma. No clinical significances of the expressions of Bmi-1,Mdm2 and Ki-67 are found in extrahepatic biliary duct carcinomas.