Objective To study the lung protection of ambroxol in general thoracic surgery perioperation for the elderly.Methods Totally 130 hospitalized patients aged (65.1±4.3) years in our hospital during general thoracic surgery were randomly divided into two groups:ambroxol intervention(2 mg/kg,intravenous drip,once/d) and control groups (n=65 for each).The incidenceof pulmonary complications,changes of blood gas analysis before and after surgery and time of hospitalization were compared between the groups.Results The incidence of pulmonary complications was significantly lower in ambroxol intervention group than in control group (9.23％ vs.24.62％,P＜0.05).Blood gas analysis results before and after surgery were improved in ambroxol intervention group[PaO2:(61.32±8.65) mm Hg,(95.07±13.62)mm Hg; PaCO2:(44.15±5.52)mm Hg,(37.28±4.06)mm Hg] as compared with control group[PaO2:(62.11 ± 8.83) mm Hg,(80.37±10.46)mm Hg; PaCO2:(44.39±5.17) mm Hg,(40.73±4.51)mm Hg] (t=3.61,3.75,both P＜0.05).The time of hospitalization was shorter in ambroxol intervention group than in control group [(12.14±0.29) d vs.(15.85±0.62)d,t=3.41,P=0.036].Conclusions Perioperative use of ambroxol in general thoracic surgery in the elderly is worthy of clinical application because of reduction of pulmonary complications and shortness of hospital stay.

Mammography imaging is one of the most demanding imaging modalities from the point of view of the bal- ance between image quality (the visibility of small size and/or low contrast structures) and dose (screening of many asymptomatic people). Therefore, since the introduction of the first dedicated mammographic units, many efforts have been directed to seek the best possible image quality while minimizing patient dose. The performance of auto- matic exposure control (AEC) is the manifestation of this demand. The theory of AEC includes exposure detection and optimization and also involves some accomplished methodology. This review presents the development and present situa- tion of spectrum optimization, detector evolution, and the way how to accomplish and evaluate AEC methods.
Humans ; Mammography ; methods ; Phantoms, Imaging ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted

Objective To study the time the liver injuries appeared,the different level of liver injury induced by injecting Cisplatin and Carboplatin in mice and the possible mechanisms of the liver injury.Methods Mice were intravenously given,Cisplatin(17 mg/kg),Carboplatin(67 mg/kg) respectively.In the 3th,7th,11 th and 14th day after injecting the medicines,the serum biochemistry parameters,oxidation and antioxidation parameters of liver and histopathologic change in hepatic tissue were observed.Results HE stain showed that fatty degeneration of hepatocyte in the two experiment groups in the 3th day after injecting medicines,and hepatocellular spotty necrosis,and infiltration of inflammatory cells arroud the necrotic liver were found in,Cisplatin group.The level of aspartate aminotransferase and alkaline phosphatase in the two experiment groups increased significantly compared with those in the control (group P＜0.01),and alanine aminotransferase in Cisplatin group increased significantly(P＜0.01),compared with that in the control group and Carboplatin group.Conclusion Hepatic injury was observed in the 3th day after injecting medicines,the level of liver injury in Cisplatin group was heavier than that in Carboplatin group.

To summarize the accumulated successful experiences, defeated cases and lessons the recent year’s clinical studies, works and experiences of hip prosthesis combining the relevant status abroad and to analyze some questions such as the operations are not standardized; the indications are not strict; overemphasizing the navigation and mini-invasion; clinical techniques are irregular, and the patients should be educated, and so on. The above questions influence the good development of the Chinese joint prosthesis and reduce the clinical outcomes of the joint prosthesis. Taken together, these questions should be concerned and resolved. Relevant solutions are discussed.

AIM:To study the role of Rhodiolae rosae in post myocardial infarction angiogenesis and its effect on extracellular regulated kinases(ERK 1/2). METHODS: The experimental myocardial infarction was made by ligation of rat left anterior descending coronary artery,and then divided into Rhodiolae group and saline group.The sham operation group and normal group were also made as control one.On the first,the 4th,the 7th and the(14th) day after the operation,rats were sacrificed and infarcted border tissue or normal tissue were used to test VEGF receptor Ⅱ and CD34 expression level and ERK 1/2 activity level. RESULTS: ERK 1/2 activity level from the first to the 4th day,VEGF receptor Ⅱ and CD34 expression level from the 4th to the 14th day after the operation,were all higher in the Rhodiolae group than that in the saline group. CONCLUSION: Rhodiolae rosae can elevate ERK 1/2 activity which was related to and prior to its angiogenic effect.

Objective To investigate the feasibility and the perioperative treatments of repairing atrial septal defects and bilateral lung transplantation in treatment of ASD with Eisenmenger's syndrome.Methods On May 24th,2016,one case of atrial septal defect with Eisenmenger's syndrome underwent repair for the atrial septal defect with bilateral sequential lung transplantation aided by extracorporeal circulation ECMO in Zhongshan People's Hospital.In strict accordance to the procedure,the lung was collected and preserved with the HTK solution.The operation went smoothly,the cold ischemic time for the right lung was 120 min and that for the left lung was 260 min.Postoperatively,Tacrolimus (FK506) + Mycophenolate Mofetil (MMF) + adrenal cortical hormone Sanlian immunosuppression was used.Results At 60th h post-operation the patient was hemodynamically stable,with good oxygenation after removal of the ECMO.At 7th day post-operation the patient was extubated.At 12th-20th day post-operation bacterial culture of the sputum was found to be positive and the patient was treated with the corresponding sensitive antibiotics and recovered.Cardiac ultrasound before discharge showed that there was no residual shunt.One month after discharge the cardiopulmonary function of the patient was quite good,chest X-ray showed that the bilateral transplanted lungs were clear and the patient's quality of life was much better.Conclusion Cardiac malformation repairs with bilateral lung transplantation is a feasible treatment for patients with end-stage Eisenmenger's syndrome with bi-directional shunts.The key to success is sufficient preoperative preparation,and a smooth operation with the timely and effective treatment of postoperative complications.

Objective To evaluate the effect of molecular adsorbent recirculating system(MARS)in treatment of severe pneumonia complicated with multiple organ dysfunction syndrome(MODS).MethodsSeventy-five patients who were diagnosed as severe pneumonia complicated with MODS were randomly divided into MARS group,continuous renal replacement therapy(CRRT)group and routine comprehensive therapy group.Flow dynamics,respiration function,liver function and renal function,coagulation function,inflammatory mediators,and Marshall scores were measured and compared before and after the treatment. The survival curves in 60 days were also compared among three groups.Results With MARS therapy,mean heart rates,peak inspiratory airway pressure,serum TBil,plasma D-dimmer levels and Marshall score were decreased;mean artery pressure,PaO2,oxygenation index,urine output,and platelet counts were increased;the levels of proinflammatory(NO,IL-6,IL-8,TNF-α and LBP)and anti-inflammatory(IL-10 and IL-13)mediator were decreased remarkably.The differences of these indicators between MARS group and other two groups were statistically significant(P＜0.05).And after MARS therapy,respiratory rate and Cr level were decreased,while SaO2 and WBC were increased significantly(P＜0.05).The 60 day-survival rate in MARS group was 80%(20/25),36%(9/25)in routine comprehensive therapy,and 52%(13/ 25)in CRRT group(P＜0.05).Conclusion MARS therapy has better effect on severe pneumonia conplicated with MODS than routine comprehensive therapy and CRRT.

Objectives:To find out the relation between main clinical character and telomerase activity in oral squamous cell carcinomas. Methods:Telomerase activity was detected by telomerase PCR ELISA assay in 12 cases of oral normal tissue and 45 cases of oral squamous cell carinoma. Results:Telomerase activity was not detectable in 12 cases of oral normal tissue. Telomerase activity was detected in 75.67 percent of oral squamous cell carcinomas. Telomerase activity was present more frequently in advanced oral squamous cell carinoma than in the early stage( P

Objective To observe the clinical efficacy and safety of 2 differentdoses of dexmedetomidine combined with low-concentration ropivacaine during lumbar plexus block for elderly patients. Methods Ninety elderly patients were randomly divided into group A,B and C with 30 cases in each group. All patients were performed lumbar plexus block guided by ultrasound and nerve stimulator.35 mL of 0.25% ropivacaine was injected in group A,35ml of 0.25% ropivacaine plus dexmedetomidine 0.5 μg/kg in group B,and 35 mL of 0.25% ropiva-caine plus dexmedetomidine 1 ug·kg-1in group C. Onset time,duration,blocking extent and the occurrence of adverse events wererecordedafter lumbar plexus block.Ramssay sedation score,blood pressure,heart rate and res-piration were monitored intraoperatively,and the dosage of analgesic within 24 hours after operation was measured. Results Group C witnessed the shortest onset time of sensory and motor block and the longest duration,followed by group B and A(P<0.01).The Ramssay sedation score of group C was higher than that of group A and B(P<0.05),but no significant difference was found between group A and B. Group C witnessed the lowest blood pres-sure and heart rate(P < 0.05),followed by group A and B(P < 0.05). The dosage of analgesics in group C was less than thatof group A and B(P<0.05),withthe lest in group B(P<0.05).All patients in group B and C com-pleted the surgery only under nerve blockade.However,there were6 patients in group Arequiring additional intrave-nous anesthesia to complete the surgery for poor outcome of nerve blockade. Conclusions The mixture of 0.5~1 μg·kg-1dexmedetomidine and 0.25% ropivacaine in lumbar plexus block can achieve good anesthetic outcome for elderly patients,with moderate sedation,stable respiration and circulation,and less adverse events.

Objective To compare the the levels of serum adipose factors and glucagon like peptide-1 (GLP-1) in patients with stable coronary artery disease ( SCAD ) and different body mass index (BMI). Methods From August 2011 to December 2013, seventy-nine patients with stable coronary artery disease (SCAD,n＝79) undergone coronary angiography and controls with matched age and sex (n＝80) in Beijing Anzhen Hospital, Capital Medical University with stable coronary heart disease with normal body mass and obesity confirmed by coronary angiography (CAG) were selected,and eighty non CHD patients confirmed by age and sex matched by CAG were selected as the control group. According to the body mass index ( BMI) and the diagnosis of coronary heart disease,the subjects were divided into normal group (n＝40,BMI＝18. 5-24 kg/m2), obesity group (n＝40,weight≥28 kg/m2),SCAD group (n＝39) and obesity SCAD group (n＝39). The levels of TNF-α,HMW-APN,Irisin,FGF-21,GLP-1,Apelin were measured by enzyme-linked immuno sorbent assay (ELISA). Results The serum GLP-1 and HMW-APN level of obesity participants was (18. 50±5. 27)ng/L, (3. 85±1. 59) mg/L,much lower than those in non-obesity participants ((20. 35±5. 5)ng/L,( 4. 57±2. 01) mg/L( P＜0. 05). The serum GLP-1 level of obesity SCAD group ((17. 59±5. 13)ng/L) was also lower than that in SCAD group ((21. 21±5. 06) mg/L) (P＜0. 05). The level of FGF-21 was negatively correlated with fasting blood glucose (r＝－0. 169,P＜0. 05). Conclusion The decrease of GLP-1 level was associated with obesity and stable coronary heart disease. Irisin,FGF-21 and Apelin were found to have no predictive value for obese patients with stable coronary heart disease