Objective To evaluate the value of low dose multilayer spiral CT (MSCT) threedimensional reconstruction in diagnosis of children tracheobronchial foreign body.Methods Forty-three children with tracheobronchial foreign body which was confirmed by fiberoptic bronchoscopy were enrolled,and all of the children underwent low dose MSCT three-dimensional reconstruction.The volume data were reconstructed on work station (Siemens) with the techniques of multiple plane reformation (MPR),curved planar reconstruction (CPR),minimum intensity projection (MinIP),volume rendering (VR),CT virtual bronchoscopy (CTVB),and the results of MSCT were compared with fiberoptic bronchoscopy.Results The fiberoptic bronchoscopy results were used as the localization and qualitative diagnosis results.Locations of the foreign body were trachea and bifurcation of trachea (6 cases),right bronchus (23 cases) and left bronchus (14 cases),and the coincidence rate of localization diagnosis of MSCT was 100％ (43/43).Natures of the foreign body were nuts in 21 cases,beans in 5 cases,corn in 2 cases,fruits and vegetables in 6 cases,and other kinds in 4 cases.Qualitative diagnosis by MSCT was medium density foreign body,and the coincidence rate was 100％ (38/38).Five cases had bone mass,qualitative diagnosis by MSCT was high density bony foreign body,and the coincidence rate was 5/5.In 43 children,MPR (CPR) showed 41 cases (95.3％),CTVB showed 33 cases (76.7％),MinIP showed 34 cases (79.1％),VR showed 23 cases (53.5％),and axial scan showed 21 cases (48.8％).MPR (CPR) in showing foreign body rate was higher than other several postprocessing methods,and there were statistical differences (P ＜ 0.05).There was no statistical difference in the showing of foreign body between CTVB and MinIP (P ＞ 0.05),but CTVB and MinIP were higher than VR and axial scan,and there were statistical differences (P ＜ 0.05).Conclusions Low dose MSCT three-dimensional reconstruction is satisfactory in the diagnosis of children tracheobronchial foreign body.It can accurately evaluate the exact size,location,shape and pulmonary complications of foreign body,thus it plays an important role in the diagnosis of suspicious tracheobronchial foreign body.

BACKGROUND: Old people above 80 years old have a high incidence of dizziness and tumble, which are associated with weakening vestibular function, balance function and optokinetic function.OBJECTIVE:This study was designed to make a quantitative evaluation of vestibular function,balance function and optokinetic function in people over 80 years old.DESIGN:It was a quantitative study on posture function(vestibular and balance function),auditory function(frequency audiometry)and visual function (optokinetic function) in elderly persons.SETTING:Department of Otolaryngology ,General Hospital of Chinese PLA.PARTICIPANTS:Totally 41 old male inpatients with systemic diseases in Rehabilitation Department of the General Hospital of Chinese PLA, with an age from 80 to 94 were selected from March 1993 to January 1994.Of them,12 had tinnitus,20 had dizziness.During the same period,old cadres including 11 males and 7 females aged from 60 to 79 years with normal findings of physical examinations were selected as controls. No participant in this group suffered from tinnitus, deafness and dizziness. All the participants were voluntary.METHODS: Patients underwent full-scale otolaryngological examinations.Audiometry consisted of battery of tests including frequency audiometry and evoked auditory brainstem responses(ABR). Vestibular function (posture) was assessed by vestibular-ocular reflexes. Participants accelerated from 1 /s to 90 /s. Then, the angular speed was kept until the nystagmus disappeared,at the time a sudden stop was made.Changes in nystagmus during the tests were recorded.The eyes firstly turned to left and 10 minutes later turned to right.Slow-phase angular velocity was recorded and the imbalanced left/right rate was calculated.Vestibularspinal reflex (VSR) was measured using balance beam and the length of the sway of the center of gravity (CG) and the sway velocity of CG were all calculated. Balance tests using a cursor were employed to examine the central optokinetic system, including sweeping, tracking, and optokinetic responses.MAIN OUTCOME MEASURES: Frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were examined to assess the posture function, auditory function and visual function in elderly persons over 80 years old.And the results were compared with those of balance function tests and visual function tests in old population aged from 60 to 79 years old.RESULTS:Practically,the number of old participants over 80 years old receiving the tests of frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were 41,24,39,40 and 34 respectively;The number of 60-79 participants receiving balance tests and visual tests were 18 and 10.Individuals refusing to participate were omitted. ① Auditory function:In 41 elderly persons ＞80 years,13 ears (16％) had a normal middle frequency audiometry, 69 ears (84％) had a loss of hearing. ② Posture function: 15 (62％) had normal vestibular-ocular reflexes, and 9 (38％) had abnormalities in vestibular-ocular reflexes.Ten (26％) had a normal vestibular-spinal reflex and 29 (74％) had an abnormal vestibular-spinal reflex.③ Balance function:Of all the variables of balance function,the length of the sway of CG and the sway velocity of CG were most valuable. In populations in both brackets, the length of the sway of CG and the sway velocity of CG in eyes-closed condition were longer and faster than those in eyes-opened .condition (P ＜ 0.01). In over 80 years group,the length of the sway of CG and the sway velocity of CG were longer and faster than in 60-79 group (P ＜ 0.01). ④ Optokinetic responses:Optokinetic plus were not obviously different between over-80 group and 60-79 group (P ＞ 0.05) and the latent period of sweeping and the distortion of tracking were significantly longer and greater in former group than in later(P ＜ 0.05-0.01 ).CONCLUSION:Most of the elderly persons over 80 years have a decrease in auditory and posture functions.Their optokinetic and balance functions are degenerated more severely than 60-79 years old population.

Objective To investigate the techniques,safety,and efficacy of intraoperative holmium laser lithotripsy under cholangioscopic visualization for refractory intrahepatic stones. Methods A total of 38 patients with refractory hepatolithiasis underwent cholangioscopic holmium laser lithotripsy.The laser setting was: the wavelength of 2.1 ?m,the maximum mean output power of 100 W,the pulse peak power of up to 6 kW,and the laser fiber of 400 ?m in diameter.Results The stones were entirely removed on one session in all the 38 patients.The lithotripsy time was 3~5 min,the times of fragmentation was 3~8,and a total of 65 stones were fragmented.No bile duct injuries or biliary leakage happened.Cholangiography and B-ultrasonography at 2 postoperative months found no residual stones.Follow-up for 6 months found no recurrence.Conclusions Application of holmium laser lithotripsy under cholangioscopic visualization for the management of refractory intrahepatic stones is safe and effective.

[Objective] To investigate into the cellular mechanism of growth promotion due to shear stress by studying G1-phase events responsible for the suppression of cell transition from the G1 to S phase of the cell cycle,and to establish the most suitable physiological stress to stimulate bone formation.[Methods]The osteoblasts derived from Kunming murine's calvaria were exposed to Fliud shear stress(FSS:12 dyn/cm2)for 0,0.25,0.5,1,2,4 h,respectively.In the flow chamber,its impact on cell proliferation,differentiation and the effection of cell cycle's G1/S checkpoint were recorded.The cell proliferation was studied by MTT assay.The cell differentiation was assessed through alkaline phosphatase(ALP)activity assay.Flow-cytometry,immunofluorescence and RT-PCR techniques were used to evaluate the proportion of S phase in cell cycle,the activity of CDK2,CDK4 and the expression of E2F-1,p27mRNA,which demonstrate how FSS underlying multiple mechanisms to enhance the cell cycle progression from G1 to S phase.[Results]FSS increased proliferation and advanced the time in cell growth curve,but after 1,2,4 h,the proliferation was inhibited.The FSS also increased the ALP activity,which were significantly stimulated at 0.25 and 0.5 h after shear stress(128% and 158 % of control);but the FSS decreased ALP activity at 1,2,and 4 hs.The proportion of S phase in cell cycle raised within the early period.The S phase rate significantly increased at 0.5 h(P

Objective To investigate the regulatory effect of fluid shear stress(FSS) on the proliferation and differentiation of osteoblasts,as well as the expression of apoptosis-inducing factor,SIVA-1.Methods The third-passage osteoblasts were divided into five experiment groups and one control group.In the experiment groups,1.2 Pa FSS were given to the osteoblasts for 0.25,0.5,1,2,and 4 hours respectively,while the control group received no FSS.Afterwards,the cells were harvested to measure MTT value and ALP activity;mRNA level of SIVA-1 were determined by RT-PCR.Results MTT revealed that the cells proliferation markedly increased in the 0.25 h and 0.5 h experiment groups with advanced cell growth curve;whereas significantly inhibited in 1,2,and 4 h groups.The FSS also increased the ALP activity at 0.25 and 0.5 hour,especially in the 0.5 h group(2.4320?0.205 S unit/100ml,158% of the control;P

Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.

Objective To observe the effect of intensive insulin therapy (ⅡT) on prognosis of severe chest trauma (SCT) pateints.Methods 42 consecutive patients were randomly assigned to 2 groups:ⅡT group (n =21) and the conventional insulin therapy group (CIT group,n =21).Blood glucose was maintained at the level of 4.4 -6.1mmol/L in ⅡT group,and 10.0 -11.1mmol/L in CIT group.The 2 groups were observed in terms of fatality rate during hospital stay,infection rate,the duration of mechanical ventilation,ICU stay length,pleural drainage day and count of neutrophils.Results No death or hypoglycemic reaction happened during hospitalization.Compared to CIT group,infenction rate,mechanical ventilation time,ICU stay length,and the time required for white blood cell to resume normal in ⅡT group were decreased significantly ( P ＜ 0.05 ).The difference had no statistical significance between the 2 groups in duration of pleural drainage and incidence of hypoglycemia (P ＞ 0.05).Conclusion ⅡT improves the short-term prognosis of SCT patients.

To investigate the effects of Crocodile Bone Gelatin(CBG) on stress reaction and blood forming function in mice. Results showed CBG increased staying power for high temperature and low temperature, but didn′t increase anti exhaustion ability and hypoxia tolerance of mice. CBG increased platelet count, didn′t increase white blood cell count on Cyclophosphamidum causing blood forming functional obstruction.

Objective To investigate the effects of prostaglandin E1 (PGE1) on the levels of myocardium nuclear factor‐κB (NF‐κB) and plasma tumor necrosis factor‐α (TNF‐α) in patients underwent heart valve replacement .Methods Forty ASA Ⅱ orⅢ degree patients (NYHA Ⅱ or Ⅲ degree) ,aged 32 to 67 years with body mass index of 17 to 28 kg/m2 ,underwent heart valve replacement ,were randomly divided into 2 groups (n=20):control group (group C) and PGE1 group (group P) .After induction of anesthesia ,PGE1 20 ng · kg -1 · min-1 was infused intravenously in group P ,while the equivalent volume of normal saline was giv‐en in group C ,and the infusion was completed at the end of operation .Arterial blood samples were collected at the time of before cardiopulmonary bypass (T0 ,baseline) ,30 min after the begin of cardiopulmonary bypass (T1 ) ,the end of cardiopulmonary bypass (T2 ) ,and 12 h(T3 ) ,24 h(T4 ) after the end of cardiopulmonary bypass .Myocardial specimens were obtained from right auricular appendage at T0 and T2 for microscopic examination and determination the activity of NF‐κB .Results The plasma mass concentra‐tions of TNF‐αwas significantly lower (P<0 .05) at T1 to T4 ,while the myocardial histopathological damage was lighter and the activity of NF‐κb significantly attenuated (P<0 .05) at T2 in group P than that in group C .Conclusion PGE1 can attenuate myo‐cardial injury in patients underwent heart valve replacement ,the mechanism is related to inhibit the activity of myocardium NF‐κB and decrease the plasma mass concentrations of TNF‐α.

Objective: To explore the position change of the setup reference markers on the sternum due to the change of hands grip position. Methods: Six hands grip positions were simulated for 8 patients and the set-up reference points marked on the sternum skin were compared while the hands grasped different positions of the hands. Results: The setup markers on the sternum were deviated by all five hands grip positions. The maximum deviated distance was 14mm. Conclusion: The change of the hands grip position can affect the position of setup reference markers on the sternum of the patients and thus the isocenter of plan may be aligned to the wrong area.