Objective To evaluate the role of thoracoscopy-assisted mini-incision in surgical treatment of lung tuberculosis.Methods From 1999 to 2004,pulmonary lobectomy was performed with thoracoscopy-assisted mini-incision(5-7 cm) on 42 patients with lung tuberculosis(right superior lobectomy in 16,right middle lobectomy in 4,right inferior lobectomy in 4,left superior lobectomy in 10,left lingular lobectomy in 4,and left inferior lobectomy in 4).Results None of the patients were converted to open surgery.The mean operation time was 105 min(35-170 min);blood loss ranged 100-800 ml(mean,150 ml).In the patients,thoracic drainage lasted for 1-5 d(mean,2.8 d) after the operation,and the hospital stay was 4-11 d(mean,6.7 d).During a 2-to 13-month follow-up(mean,8.2),no patient showed positive sputum,bronchopleural fistula,or diffusion of tuberculosis.Conclusions Since thoracoscopy-assisted mini-incision is assosiated with minimal tissue injury,few blood loss,quick postoperative recovery,short hospital stay,and few complications after the surgical treatment of lung tuberculosis,it is worth being widely used.For surgeons,it is important to remember the indications for the procedure.

Objective To explore the effects of human menopausal gonadotropopin(HMG) supplementation on the outcome of women underwent in vitro fertilization-embryo transfer(IVF-ET) .Methods The data of 406 IVF-ET cycles in Reproductive Medi-cine Center of the 105th Hospital of PLA were analyzed retrospectively .All cases underwent long down regulation protocol with gonadotropin releasing hormone agonist(GnRH-a) in the mid-luteal phase and controlled ovarian stimulation(COS) was carried out with follicle stimulation hormone(r-FSH) on the days 3 -5 of the menstrual cycle .Then 75 -150 U HMG was administrated in group A(257 cycles) when a dominant follicle reached a diameter of 14 mm ,while the remaining cases(149 cycles) underwent HCG still with r-FSH were served as group B .Based on the LH levels on the day of HMG administration ,the cases in group A were sub-divided into :group A1(99 cycles) ,LH<1 U/L ;group A2(96 cycles) ,1 U/L≤LH≤2 U/L ,and group A3(62 cycles) ,LH>2 U/L .Clinical outcomes of all groups were analyzed and compared .Results The durations and doses of gonadotropin(Gn) ,the rates of fertilization and pregnancy were higher and the abortion rate was lower in group A than that in group B (P<0 .05) .There were no significant difference in serum LH concentrations on the days of HMG and HCG administration ,oocytes retrieved ,the rates of cleavage and embryo implantation between group A and group B(P>0 .05) .There was significant difference in serum LH levels on the day of HMG supplementation among group A1 ,A2 and A3(P<0 .05) and the doses of HMG supplemented reduced gradually from group A1 to group A3(P<0 .05) .The duration of Gn was significantly lower and the fertilization rate was significantly higher in group A3 compared with group A1 and A2(P<0 .05) .The pregnancy rate in group A2 and A3 was higher than that in group A1 ,which showed significant difference between group A2 and A1(P<0 .05) .Meanwhile ,there were no significant difference in doses of r-FSH ,serum LH concentrations on the day of HCG administration ,oocytes retrieved ,the rates of cleavage ,implantation and abortion among the three groups(P>0 .05) .Conclusion HMG supplementation in the middle and late follicle phases in stand-ard long down-regulation protocol during IVF could obtain higher pregnancy rate and lower abortion rate ,especially when their ser-um LH level was between 1 U/L and 2 U/L without obvious increase of LH .

Objective To investigate the changes and clinical significance of calcitonin gene related peptide (CGRP) and interleu-kin 1α(IL-1α) before and after warm acupuncture therapy in the patients with lumbar disc herniation (LDH ) .Methods Serum CGRP and IL-1αcontents were detected before and after the warm acupuncture therapy in 60 cases of lumbar disc herniation and 15 healthy control cases by ELISA method for conducting the statistical analysis .The changes of the McGill pain scores and serum CGRP and IL-1αconcentrations before and after the warm acupuncture therapy were observed .Results The McGill pain scores af-ter the warm acupuncture therapy in the LDH patients were significantly decreased ,the difference was statistically significant (P<0 .01) ,and serum CGRP and IL-1α concentrations were significantly decreased ,the difference was statistically significant (P<0 .01) .Conclusion CGRP and IL-1αcan be used as the observation index of the effects for the warm acupuncture therapy in trea-ting LDH ,which can provide the basis for the conservative treatment of LDH .

OBJECTIVE:To improve the quality standard of Shuangshen capsule. METHODS:TLC was conducted for the qual-itative identification of Curcumnae radix and Rehmannia glutinosa in the preparation. HPLC was used for the content determination of salvianolic acid B in the preparation:the column was Diamonsil C18(2)with mobile phase of acetonitrile-0.1% H3PO4(22:78, V/V) at a flow rate of 0.5 ml/min,detection wavelength was 286 nm,column temperature was 30 ℃,and the injection volume was 2 μl. RESULTS:The TLC spots of C. radix and R. glutinosa were clear and well separated;the linear range of salvianolic ac-id B was 0.0792-0.792 μg(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 100.71%-101.82%(RSD=0.50%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Shuang-shen capsule.

A 47-year-old man presented with recurrent oral ulcerations for more than 1 year and generalized vesicles for 9 months.Physical examination revealed multiple oral ulcers,patchy labial erosions with yellow or dark brown crusts,maceration and blanching of the angle of mouth resulting in difficulty in mouth opening.Cinnamomeous crusts were seen on the nasal limen,palpebral margin and coronary sulcus of penis,with pale red macules after decrustation.Diffuse erythematous patches and bullae were present on the trunk and extremities.The walls of bullae tightly clung to the skin,and some bullae were ruptured,leaving an erythematous and moist surface and giving an erythema multiforme-like appearance; some bullae were turbid and covered with adherent drugcontaining white crusts or black crusts.Nikolsky's sign was negative.Shrinking,edematous dark-red patches were seen in periungual regions of all the fingers and toes.Histologic biopsy and direct immunofluorescence examination of bullous lesions confirmed a diagnosis of paraneoplastic pemphigus (PNP).Histopathological and immunohistochemical findings from the mediastinal tumor were consistent with Castleman's disease (hyalinevascular type) with proliferation of follicular dendritic cells.Laboratory examination revealed a decrease in serum complement C3 and the presence of antinuclear,anti-nucleosome and anti-dsDNA antibodies.The final diagnosis included Castleman's disease,PNP and systemic lupus erythematosus.After 2 months of treatment with low-dose prednisone and azathioprine,skin lesions completely regressed.Then,the dose of prednisone and azathioprine was tapered.Six months later,the patient himself suddenly withdrew prednisone and azathioprine,and began to take traditional Chinese medicine; thereafter,the lesions developed into toxic epidermal necrolysis (TEN),and the patient died finally.This case demonstrates that immunosuppressive therapy should be maintained for a long period of time in patients with Castleman's disease after tumor removal,otherwise,skin lesions may recur or get worse.

OBJECTIVE To investigate the disinfectant-resistant gene qacE△1-sul1 in Pseudomonas aeruginosa isolated from burned patients. METHODS GNS-448 and K-B tests were performed to detect the susceptibility of 19 kinds of antimicrobial agents against these strains. Genotype was analyzed by polymerase chain reaction(PCR) and verified by DNA sequencing. RESULTS The 32 strains isolated were all resistant to ampicillin,cefuroxime,cefoxitin,SMZ/TPM. The sensitive rates to amikacin and gentamicin were 68.0%,and 46.9%,respectively,the resistant rates to imipenem and meropenem were 68.8% and 59.4%,respectively. The positive rate of gene qacE△1-sul1 was 50.0%. CONCLUSIONS The resistance of P. aeruginosa isolated from burned patients is a serious issue.There is high positive percentage of qacE△1-sul1 gene in P. aeruginosa isolated from burned patients.

OBJECTIVE To investigate the 16S rRNA methylase gene and aminoglycoside-modifying enzyme genes in Pseudomonas aeruginosa isolated from burned patients. METHODS GNS-448 and K-B tests were performed to detect the susceptibility to 19 kinds of antimicrobial agents against these strains. 16S rRNA methylase gene and aminoglycoside-modifying enzyme genes were amplified by polymerase chain reaction (PCR) and verified by DNA sequencing. RESULTS The 32 isolated strains were all resistant to ampicillin,cefuroxime,cefoxitin,SMZ-TMP,The sensitive rates to amikacin and gentamicin were 68% and 46.9%,respectively. The resistant rates to imipenem and meropenem were 68.8% and 59.4%,respectively. The 16S rRNA methylase gene and aminoglycoside-modifying enzyme genes including aac(6')-Ⅰb,aac(6')-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ and rmtB were found and positive rates were 9.4%,3.1%,28.1%,25.0% and 3.1%,respectively. A novel subtype of aac(6')-Ⅰb was reported firstly. CONCLUSIONS There are high positive percentage of 16S rRNA methylase gene and aminoglycoside-modifying enzyme genes in P. aeruginosa isolated from burned patients. P. aeruginosa resistance to aminoglycoside relates to the existence of 16S rRNA methylase gene and aminoglycoside-modifying enzyme genes.

Objective To investigate the causes , surgical methods and complications of reoperation of thyroid carcinoma and management .Methods Clinical data of patients with thyroid carcinoma in Department of General Surgery of Tang Du Hospital during Jan .2007 to Apr.2012 were retrospectively analyzed .The causes and complications were studied.Results Postoperative complications happened to 5 cases(13.51%), among whom 2 cases had temporary recurrent laryngeal nerve palsy and they recovered after 2 to 6 months , 2 cases had temporary hypocalcemic convulsions and the symptom resolved after one-week treatment with intravenous calcium gluconate , and 1 case had bucking and recovered after one week of treatment .Conclusion For patients with thy-roid disease,detailed preoperative examination , intraoperative frozen pathological examination , intraoperative explo-ration and the right operation method are the key factors to prevent thyroid carcinoma reoperation .Careful dissection and gradually sever of upper pole of thyroid lobe reduce complications of thyroid carcinoma reoperation .

Objective To analyze the changes of serum levels ofαII-spectrin breakdown products (SBDPs)in traumatic brain inj ury (TBI)patients,and further to investigate the clinical diagnosis value of SBDPs for patients with TBI,especially with mTBI.Methods The serum levels of SBDPs were examined in 43 severe TBI (sTBI)patients,43 mild TBI (mTBI)patients and 43 healthy controls using enzyme linked immunosorbent assay (ELISA).The diagnostic usefulness of SBDPs for TBI patients were assessed by Receiver Operating Characteristic (ROC)curves analysis.Results There was no significant difference of SBDP145 among the three groups (F=1.340,P>0.05).Serum levels of SBDP120 in controls,mTBI and con-trols were 7.06±2.23,11.67±9.14 and 12.64±11.44 ng/ml,respectively.Compared with controls,serum levels of SB-DP120 were significantly higher in patients with sTBI (F=9.873,P=0.001)and mTBI (F=9.873,P=0.008),while there was no significant difference of SBDP120 between sTBI patients and mTBI patients (F=9.873,P=0.515>0.05). The area under ROC curve (AUC)of SBDP120 for TBI patients was 0.781 (95% CI:0.690~0.872,P<0.001).For mTBI patients,the area under ROC curve was 0.736 (95% CI:0.624~0.848,P<0.001).And for discriminating TBI patients with CT negative or positive,the area under ROC curve was 0.709 (95% CI:0.582~0.837,P=0.007<0.01).Conclusion The serum levels of SBDP120 were significantly increased in TBI patients,especially mTBI patients.And the serum levels of SBDP120 can be used as potential non-invasive biomarker for mTBI patients.