Objective To investigate the diagnostic value and safety of medical thoracoscopy in unexplained exudative pleural effusion.Methods A retrospective analysis was conducted using the clinical data of 70 routine medical thoracoscopy examinations of unexplained exudative pleural effusion in patients.The lesions were examined pathologically under direct vision.Results White military nodules were observed under endoscopy,with multiple pro-truding nodules,focal irregular thickening of the pleura,pleural congestion,edema and adhesion.The diagnostic accu-racy of thoracoscopy was 95.7%.Among the diagnosed cases,there were 35 cases of tuberculous pleurisy,20 cases of malignant pleural effusion,8 cases of parapneumonic effusion,4 cases of pleural effusion from congestive heart failure and 3 cases of idiopathic pleural effusion,with no serious complications.Conclusion Medical thoracoscopy is a safe and accurate method in the diagnosis of unexplained exudative pleural effusion.Medical thoracoscopy is beneficial in the establishment of treatment method quickly and allows observation of the pleural lesions in pleural effusion patients using the naked eye.

Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

Objective:To investigate the correlation between the expression of Golgi phosphoprotein 3 (GOLPH3) and the occurrence of apoptosis in colorectal cancer cells (CRC). Methods:Immunohistochemical assays of GOLPH3 and caspase-3 were performed on the paraffin-embedded sections of 62 CRC samples using the standard streptavidin-peroxidase technique. The apoptotic index of the CRCs was examined using the in situ terminal deoxynucleotidyl transferase nick-end labeling technique. The relationship of the GOLPH3 expression, the cell apoptosis, and the clinicopathologic parameters was analyzed. Results:The positive rates of GOLPH3 expression were significantly higher in the CRC tissues (53.2%) than in the normal colorectal mucosa (37.2%;P<0.05). Likewise, GOLPH3 expression was significantly higher in poorly differentiated cancer tissue, tissue outside the serous membrane, metastatic lymph node tissue, and the stage III CRCs, as compared with those of the moderately to well differentiated tissue, tissue inside the serous membrane, lymph node tissue without metastasis, and the stage I to II CRCs (P<0.05). However, GOLPH3 expression was not significantly correlated with the other clinicopathologic pa-rameters, namely, the age and sex of the patients as well as the site, depth, and length of the invasive tumor (P>0.05). The caspase-3 expression and apoptotic index were significantly lower in the GOLPH3-positive CRC tissue than in the GOLPH3-negative tissue (P<0.05). GOLPH3 expression was negatively correlated with the apoptotic index of CRCs based on the Spearman correlation (r=-0.320, P<0.05). Conclusion:GOLPH3 overexpression in CRC tissue is negatively correlated with apoptotic index.

Objective To evaluate the effect of YunKe on bone metabolism of patients with rheumatoid arthritis (RA). Methods A total of 108 RA patients were divided into YunKe group (n = 72), non-YunKe group (n = 36), and 54 controls. The bone mineral densities (BMDs) of the wrists, hips and lumbar spines were measured by dual-energy X-ray absorptiometry. Moreover , the expression of cross-linked N-telopeptides of type I collagen (NTX) in the serum was detected for statistically analyzing the difference between YunKe group and non-YunKe group. Results In RA group, the BMDs of wrist, hip and lumbar spine declined compared with that of control group (P < 0.001, respectively). In YunKe group, the BMDs of wrist, hip and lumbar spine after 6 months all were improved with statistically significance (P < 0.01, respectively); The differences also were statistically significant when compared with those in non-YunKe group (P < 0.01, respectively). In YunKe group, NTX level in the serum declined after 3 months of the treatment. The difference was statistically significant when compared with that in non-YunKe group (P < 0.001), but the difference disappeared 6 months later. Conclusions The BMD of wrist joints is low and declines in RA patients significantly. The treatment withYunKe improves the BMDs of the wrist , hip and lumbar spine and decreases the serum NTX. This study proposed that YunKe could inhibit the chronic loss of bone mass induced by RA.

AIM: To probe into the development strategy, department construction and management methods of the pain department according to the current situation of pain treatment in China.METHODS: Based on on-spot investigation and individual correspondence,we made a comprehensive evaluation of the collected materials and testified them from the hospital departments involved. Under the current situation of pain treatment in China, namely, difficulty in forming a large scale and yielding social and economic results, relation between pain and rehabilitation therapy is discussed to explore the feasibility, advantages and disadvantages of combining the two.RESULTS: The construction of the pain department should make full use of the human, financial and equipment resources available in the rehalilitation department, merging the pain department with the rehabilitation department to set up the pain and rehabilitation center. It will give full play to the respective advantages and avoid the weaknesses and produce large-scale results. The ward layout should consist of pain, rehabilitation and physiotherapy wards, operation room and nurse station. Outpatient diagnosis and treatment and the economic effect should be improved. Treatment should be centered on micro-invasive operations with comprehensive treatment as supplement so as to form the specialty-based characteristic. The department should be managed as an enterprise.CONCLUSION: The pain department should be merged with the rehabilitation department to set up the pain and rehabilitation center to achieve collaborative development.

ObjectiveTo understand the difference in characteristics between juvenile dermatomyositis (JDM) and adult dermatomyositis (ADM).Methods Sixty-one cases of JDM were retrospectively analyzed and compared with 30 cases of ADM. Results The rashes were presented as the initial symptom in all expect one JDM patients. Gottron’s papules were presented in 90% JDM patients and 67% ADM patients. Calcium deposition was presented in 7% JDM patients and none of the ADM patients. The cardiovascular system was involved in 7 % JDM patients and 23% ADM patients. Cancer occurred in none of JDM patients and 13% ADM patients. In JDM and ADM patients, the ratio of elevated muscle enzymes from highest to lowest was LDH, hy-droxybutyric acid enzyme, CK-MB, AST, and CK. The positive ratio of magnetic resonance (MRI) all exceeded 80% in JDM and ADM groups. Two cases died in each group.Conclusions The clinical presentation of JDM is basically the same as that of ADM. The most common initial symptoms in JDM are skin rashes and Gottron's papules. Cardiovascular disease and cancer are less in JDM than in ADM. MRI is valuable in the diagnosis of DM.

Objective To refine the technique and improve the efficacy of seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle disease.Methods The refined techniques of seminal vesculoscopy,using a patent catheter into the slit-like ejaculatory duct orifice through the verumontanum and another patent catheter introduced into seminal vesicle lumen,were performed in 58 cases,including intractable hematospermia in 42 cases and azoospermia in 16 cases.Results Seminal vesiculoscopy was successfully entered into the seminal vesicular lumen in 46 patients (79％) within 2-3 min.There was no obvious ejaculatory duct orifice in 12 of 16 azoopermia cases,and transurethral resection of verumontanum was performed,then seminal vesiculoscope was directly entered into seminal vesicle lumen.Symptoms of hematospermia were disappeared in 25 cases (60％),improved in 11 cases (26％),and azoospermia were cured in 6 cases (37％),improved in 5 (31％),unchanged in 5 (31％) during the follow-up period of 6-36 months (average 18 months).There were no major or minor complications in this series,and no urine reflux into ejaculatory duct in 19 cases demonstrated by contrast medium.Conclusion Refined seminal vesiculoscopy was technically safe,efficient,simple,and potentially widely used in the cases of hematospermia and ejaculatory duct obstructions.

Objective To establish a close clinical and easy to operate animal artery bypass grafting model by using vascular anastomosis wheel.Methods 15 rabbits that weighted 2.5-3.5 kg were studied.Each animal underwent an end-toend anastomosis of jugular vein and carotid artery by vascular anastomosis wheel.Carotid ultrasound and flow detection were taken immediately and 2 months after surgery respectively,as well as morphology and pathology were recorded to analyze and evaluate the intimal hyperplasia of vein graft and arteriovenous anastomotic site.Results 14 rabbits were successfully established CABG model,however 1 rabbit died of respiratory inhibition caused of excessive anesthesia.Compared with normal carotid artery,the vein bridge showed significantly lower blood flow [(50.81 ± 1.33) ml/min vs.(70.59 ± 0.68) ml/min,P ＜0.01,higher PI(2.15 ±0.07vs.1.22 ±0.04,P ＜0.01)] immediately after surgery.Compared with the vein grafts immediately after surgery,the vein grafts 2 months after surgery showed significantly lower blood flow [(27.46 ± 2.15) ml/min vs.(50.81 ± 1.33) ml/min,P ＜ 0.01].Compared with normal jugular vein,the vein grafts 2 months after surgery showed significantly higher intimal hyperplasia[(160.30 ± 1.78) μm vs.(49.06 ± 2.76) μm,P ＜ 0.01],and higher number of elastic plates(12.36 ± 0.25vs.3.21 ± 0.15,P ＜ 0.01).Conclusion The use of vascular anastomosis wheel to establish an artery bypass graft model can imitate the pathological changes of vein grafts after CABG,which can provide an ideal animal model for various researches on vein grafts.

BACKGROUND:There was no effective method to thoroughly treat tibial bone defect and soft tissue defect. The application of Ilizarov technique solved shortening deformity, soft tissue injury and joint contracture to some degrees.
OBJECTIVE:To discuss the effects of Ilizarov external fixation on treatment of tibial bone defect and the parameter selection of Ilizarov steel ring.
METHODS:We retrospectively analyzed the clinical data of 67 patients with tibial bone defects, who were treated and fol owed up from March 2007 to January 2012. Al patients had fracture of tibia and received one-stage operation. After treatment, postoperative limb suffered from tibia osteomyelitis and soft tissue injury. Ilizarov external fixation was placed in the limb. The length of defected tibia and area of defected soft tissues were compared at 1, 3 and 6 months after external fixation and final fol ow-up. The ankle joint Kofoed score and knee joint ROM score were observed before and after external fixation. In final fol ow-up, functional recovery was evaluated in accordance with diagnosis and treatment criteria of Johner-Wruhs fracture of shaft of tibia.
RESULTS AND CONCLUSION:A total of 67 patients were fol owed up for 6 to 35 months. Bone defects in 67 cases were rebuilt and the fracture was healed, but five cases had poor healing. Among 44 cases of soft tissue injury, wound had healed in 40 cases, and wound had not healed in 4 cases. The length of tibia defect and the area of soft tissue defects were improved at 1, 3, and 6 months after the operation (P<0.05). After operation, the ankle joint Kofoed score and knee joint ROM were significantly better than those before operation (P<0.05). During final fol ow-up, the excellent and good rate of each therapeutic plan was 85%. For the tibial osteomyelitis bone defect with the merged skin defect, the trauma was smal using Ilizarov technique, which can avoid several complicated operations, shorten the time and reduce the expenses of treatment, but there were some weaknesses and limitations. The size and material of Ilizarov external fixation affect the efficiency of the fixation and postfixation adjustment.

Objective:To establish a method for the detection of 8 single nucleotide polymorphisms (SNPs) of RAC1 gene,and to analyze the genotypic and allelic distributions of the 8 SNPs in healthy Chinese Han population.Methods:The real-time fluorescence TaqMan-MGB probes allele classification technology was used for the determination of the 8 SNPs in 150 cases of healthy volunteers in Hubei China ,and the results were validated by direct gene sequencing.Results: The method established in this study can accurately screen the genotypes of the 8 SNPs of human RAC1 gene.Highly linkage disequilibriums were found between rs 10951982 and rs9374 , rs702482 and 836488 ,respectively.All the 8 sits were in accordance with Hardy-Weinberg equilibrium.Six Tag-SNPs were selected by Heploview software:rs10951982 ,rs6954996 ,rs6951997 ,r1s2977 ,rs702482 and rs702483.The MAFs of the 8 SNPs in our study were close to the MAFs in CHB and Asian in Hap Map database .Significant distribution differences were also observed in different races.Conclusion:No significant differences are observed in this study in healthy Chinese Han population.But differences are found when compared with the data of other races in Hap Map.