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.

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.

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.

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.

Aim To observe the effect of mycophenolate mofetil(MMF) on expressions of MCP-1 and CD68 in renal tubulointerstitial injury of diabetic rats and explore the mechanism of MMF′s protective role.Methods Diabetes was induced in uninephrectomized male Wistar rats by peritoneal injection of STZ (65 mg?kg-1). Rats were randomly divided into three groups:control group (NC),diabetic group (DM) and treated group (DM+MMF) with MMF(15 mg?kg-1?d-1).This study lasted for 8 weeks. 24 h urinary protein,blood glucose and the ratio of left kidney weight/body weight were determined after 8 weeks.The renal tubulointerstitial morphological change was observed,immunohistochemical method was used to analyze expressions of MCP-1 protein and CD68. Expression of MCP-1 mRNA in renal tissue was measured by quantitative Real-time PCR.Results Compared with NC group, serum glucose level,24 hour urinary protein and the ratio of left kidney weight/body weight were significantly increased(P

Objective To investigate the pelvic floor in cystocele patients using translabial ultrasound,and discuss the ultrasound appearance.Methods Translabial 2D ultrasound was performed on 136 patients who were diagnosed or suspected as anterior vaginal wall prolapse or cystocele using pelvic organ prolapse quantitation system,the position of bladder,the retrovesical angle and urethral rotation were measured during maximum Valsalva maneuver.Cystocele subtypes were diagnosed according to the ultrasound findings.Results Translabial 2D ultrasound diagnosed 88 cases cystocele based on the position of bladder,retrovesical angle and urethral rotation,including ten cases cystocele type Ⅰ,32 cases type Ⅱ and the remaining 46 classified as type Ⅲ.Conclusions Translabial 2D ultrasound successfully acquired the ultrasonic characteristics of cystocele subtypes,which could provide imaging evidence for clinic diagnosis of this disease.

OBJECTIVE To analyze the value of modified sinus CT score in olfactory function evaluation before and after functional endoscopic sinus surgery in chronic rhinosinusitis with nasal polyps(CRSwNP). METHODS Fifty-four patients who underwent functional endoscopic sinus surgery for CRS with nasal polyps were enrolled in this prospective study by inclusion criteria and exclusion criteria. T&T methods and olfactory function VAS were used to analyze the subjective olfactory function and were performed preoperatively and at 6 months after surgery. In modified sinus CT score, middle turbinate and superior turbinate associated olfactory cleft areas were used to evaluate the anterior olfactory cleft score(AOCS) and posterior olfactory cleft score(POCS). Sinus CT scans Lund-Mackay scores were also collected before surgery. The correlation between the status of the olfactory cleft on CT, Lund-Mackay score and the preoperative and postoperative olfactory results were investigated.RESULTS Among 54 patients, there were 36 male and 18 female, with average age of 47.9 years old(from 24 to 67 years). There were 30 patients followed 6 months after surgery. The findings of olfactory cleft opacification and the CT Lund-Mackay scores had a positive correlation with preoperative olfactory results(P<0.001). The olfactory cleft opacification showed a stronger correlation with the preoperative olfactory results than the CT Lund-Mackay score. The AOCS was more significantly correlated with the postoperative olfactory results than the other parameters.CONCLUSION Preoperative CT findings, especially the anterior portion of the olfactory cleft had a statistically significant association with the postoperative olfactory results in patients with CRS with nasal polyps.