Objective To investigate the feasibility of video-assisted thoracoscopic surgery (VATS) for treating spontaneous chylothorax. Methods Four patients with spontaneous chylothorax were treated by VATS from April 2000 to October 2003. Results Operations were successfully completed in all the 4 patients. The operative time was 40, 52, 55, and 95 min, respectively (mean, 60.5 min). The postoperative chest drainage time was 3~8 d (mean, 5.2 d). The postoperative hospital stay was 8~13 d (mean, 10.5 d). No severe complications or operative mortality were seen. Conclusions Treatment of spontaneous chylothorax by VATS gives advantages of less invasion and quick recovery.

OBJECTIVE:To prepare jumazhitong film and establish its quality control method.METHODS:The jumazhitong film former was made with PVOH-124 as the base,the content of the principal agent-dyclonine hydrochloride was determined by HPLC.RESULTS:Good linear relation was achieved when the detection concentration range of dyclonine hydrochloride was 40.8～408?g/ml(r=0.9 998),the average recovery was 101.3%(RSD=1.3%,n=6).CONCLUSION:The preparing technique of jumazhitong film former is simple,its quality is stable and the control method is feasible.

Objective To investigate the relationship of the lymphangiogenesis and lymphatic metastasis by observing the expression of proliferating cell nuclear antigen in the hamster tongue cancer development and analyzing the correlations of lymph vessel density (LVD), lymphatic vessel area (LVA) and malignance or lymphatic metastasis of tongue cancer cells. Methods Forty_two hamster tongue cancer models were induced by painting 1.5% 7,12-dimethylben(a) anthracene (DMBA) acetone solution after scratching, 7 models were sacrificed every two weeks. The pathological changes of tongue cancer were determined by the HE staining. The lymphatic hyperplasia was determined by PCNA and Desmoplakin(DP I +Ⅱ) Immunohistochemical double staining. The tumors and lymphatic endothelial cell proliferation index (proliferation index, PI), lymphatic vessel density (LVD) and lymphatic vessel area (LVA) were measured and statistically analyzed. Results The oncogenesis of tongue was divided into three stages: atypical hyperplasia, carcinoma in situ and early invasive stage;atypical hyperplasia group:PI (91.55), LVA (7570.23), LVD (2.50);carcinoma in situ group: PI (113.36), LVA (12105.45), LVD (3.73);early invasive group: PI (124.67), LVA (14524.33), LVD (5.33). The PI, LVA and LVD were compared among groups above (P<0.05), and the correlation of PI with LVA and LVD was positive (P<0.05);Lymphatic metastasis group:PI (130.50), LVA (15430.67), LVD (6.17), non lymphatic metastasis group:PI (113), LVA (12711.67), LVD (3.67), the PI, LVA and LVD were compared between the two groups above (P<0.05).Conclusion With the development of hamster tongue cancer, lymphatic endothelial cell proliferation activity increased, suggesting that the lymphangiogenesis existed in the tongue carcinogenesis process;the values of the LVD and LVA increased in the hamster tongue cancer development, which was positively correlated with the cancer cell malignance and lymphatic metastasis.

Objective To study the protective effect of octreotide on myocardial injury after hepatic ischemia-reperfusion in rabbit. Methods Pringle's maneuver rabbit hepatic ischemia-reperfusion model was established. 24 adult New Zealand rabbits were random divided into equal 3 groups: sham operative group ( group A) , ischemia-reperfusion group( group B) and octreotide preconditioning group ( group C ). The levels of CK-MB( MB isoenzyme of creatine kinase) and LDH ( 1actate dehydrogenase), superoxide dismutase (SOD) and malondialdehyde (MDA) of each group were measured at the time before ischemia (T1) , after ischemia for 30 mins ( T2 ) and after reperfusion for 60 mins ( T3 ), 120mins ( T4 ), 240 mins ( T5 ). The SOD and MDA in myocardial tissue of each group were measured after reperfusion for 240 mins. The changes of ultrastructure in the myocardial cell were observed by transmission electron microscopy after reperfusion for 240 mins. Results There was no significant difference in the levels of CK-MB and LDH in serum of each group before ischemia ( P ＞0. 05). The CK-MB and LDH of group B and C were higher than that of group A ( P ＜0.05) after ischemia for30 mins. The CK-MB and LDH of group C were lower than that of group B in this period( P ＜0. 05 ). The highest time point of LDH and CK-MB were after reperfusion for 120 mins and 240 mins. The contents of MDA in group B and group C were higher than that in group A from after ischemia for 30 mins in plasma and after reperfusion for 240 mins in myocardial tissue ( P ＜ 0. 05 ),and it in group C were lower than that in group B( P ＜0.05) .The contents of SOD in group B and group C were lower than that in group A from after ischemia for 30 mins in blood plasma and after reperfusion for 240 mins in myocardial tissue ( P ＜0. 05), and in group C were higher than that in group B( P ＜0. 05).The electromicroscope showed that the pathological change of myocardial ultrastructure of group C was slighter than that of group B. Conclusion Octreotide can stabilize myocardial cell membrane and reduce release of oxygen free radical and significantly relieve the injury of myocardial ultrastructure after hepatic ischemiareperfusion in rabbit. Octreotide preconditioning can relieve myocardial injury after hepatic ischemia-reperfusion in rabbit.

Objective:To establish an HPLC method for the content determination of salvianolic acid B in Ansheng Yizhi cap-sules. Methods:A Hypersil ODS2 C18 column(150 mm × 4. 6 mm,5 μm) was used and methanol-water-formic acid (40∶60∶1) was used as the mobile phase. The detection wavelength was at 286 nm. The flow rate was 1. 0 ml·min-1 and the sample size was 10 μl. Results:The calibration curve of salvianolic acid B was linear within the range 7. 75-77. 51 μg·ml-1(r=0. 999 6). The average re-covery was 98. 17%(RSD=1. 79%, n=6). Conclusion:The method is simple, accurate and repeatable, which can be used in the quality control of Ansheng Yizhi capsules.

Objective To investigate the types,antimicrobial resistance,and disinfectant resistance of pathogens isolated from hospital environmental inanimate surfaces and hands of health care workers (HCWs).Methods Pathogens isolated from hospital environmental inanimate surfaces and hands of HCWs in intensive care units and general wards in 16 hospitals in Beijing were performed bacterial identification,antimicrobial susceptibility testing,and disinfectant re-sistance testing. The carriage of antimicrobial resistance genes and disinfectant genes in pathogens were also detec-ted.Results A total of 979 specimens were collected from inanimate surfaces and hands of HCWs in 16 hospitals,75 (7.66% )pathogenic strains were isolated,78.67% of which were gram-negative bacilli. The top 3 pathogens were Pseud-omonasaeruginosa (P.aeruginosa,n= 24),Enterobactercloacae (E. cloacae,n= 14),and Klebsiella pneumoniae (K. pneumoniae,n= 4 ). One P. aeruginosa strain was resistant to aztreonam,gentamycin,tobramycin,ciprofloxacin,and levofloxacin;One E. cloacae strain was resistant to piperacillin,7 strains were resistant to nitrofurantoin;4 K. pneumoni-ae strains were all resistant to piperacillin,2 were resistant to cephalosporins,and 1 was resistant meropenem. P. aerugi-nosahad7drug-resistantgenes,positiverateofmirwas100.00% ;E.cloacaehad4drug-resistantgenes,positiveratesof tem 1and shv were both 100.00% ;K. pneumoniae had 5 drug-resistant genes,positive rates of shv and mir were both 100.00% . The resistant rates of P. aeruginosa and E. cloacae to chlorhexidine gluconate were 4.17% and 57.14% re-spectively,to trichloroisocyanuric acid were both 50.00% ,positive rates of drug-resistant genes (qacE△1-sul 1)were 79. 17% and 57.14% respectively;K. pneumoniae had no resistance to two kinds of disinfectant,dug-resistance gene was not found.Conclusion Multiple common pathogens which can cause healthcare-associated infection exist in hospital environ-mental inanimate surfaces and hands of HCWs,which are dominated by gram-negative bacilli,pathogens had resistance to antimicrobial agents and disinfectant in different degrees.

BACKGROUND: Further studies are needed to understand the cytobiological character, functional regulation, gene changes and expression difference of CD34~+ and CD133~+ stem cells induced by basic fibroblast growth factor (bFGF) using gene chip. OBJECTIVE: To compare the differences of gene expression and the response to bFGF of human umbilical cord CD34~+ and CD133~+ cells, and to explore gene expression changes of bFGF-induced umbilical cord CD34~+ and CD133~+ hematopotic stem cells/hemapoietic progenitor cells in vitro. METHODS: Human umbilical cord blood CD34~+ and CD133~+ cells were isolated and purified by MiniMACS immunomagnetic beads selection. The CD34~+ and CD133~+cells were cultured for 10 to 15 days in DMEM/F12 medium, supplemented with bFGF and B27. Total RNA from these cells was extracted and the genetic level of these cells was performed using Oligo GEArray(r) chip and GEArray software. Selected rate of CD34~+ and CD133~+ hematopoietic stem cells was detected using flow cytometry. CD34~+ and CD133~+ cell morphological changes were measured before and after bFGF induction. The concentration and purity of RNA were determined by agarose gel electrophoresis degeneration. Gene-chip test results were analyzed.

Purpose To explore the diagnostic value of double exponential model for pelvic lesions using 3.0T MRI for the diagnosis of pelvic lesion. Materials and Methods Fifty patients with pelvic lesions (30 benign cases and 20 malignant cases) underwent MR750-diffusion weighted imaging (DWI) scans, with b values of 0, 50, 300, 600, 800 and 1200 s/mm2, Functool-MADC software was used on AW 451 workstations for data processing, Slow ADC value, Fast ADC value, Standard ADC value, Fraction of fast ADC value were recorded and compared between benign and malignant lesions, and Standard ADC images were fused with axial T2 fat-suppressed images. Results Slow ADC values [(1.83±0.86)×10-3 mm2/s] and Standard ADC values [(1.79±0.78)×10-3 mm2/s] of benign lesions were larger than those of the malignant lesions [Slow ADC values:(1.05±0.31)×10-3 mm2/s;Standard ADC values:(1.13±0.39)×10-3 mm2/s] (t=3.90, 3.51;P<0.01), and the difference of Slow ADC value was largest between benign and malignant lesions. Slow ADC values of both benign and malignant lesions were significantly less than the Fast ADC values [benign:Slow ADC value=(1.83±0.86)×10-3 mm2/s, Fast ADC value=(16.95±8.63)×10-3 mm2/s; malignant: Slow ADC value=(1.05±0.31)×10-3 mm2/s, Fast ADC value=(15.12±9.90)×10-3 mm2/s] (t=-10.40,-6.29;P<0.01). Conclusion Double exponential decay model is capable of differentiating benign and malignant pelvic tumors, thus is of great significance for clinical preoperative diagnosis.

Objective To evaluate the effects of dezocine on diabetic neuropathic pain (DNP ) and expression of NMDA receptor subunit 2B (NR2B) in the spinal dorsal horns of rats .Methods Forty-eight male Sprague-Dawley rats , aged 4 weeks , weighing 150-170 g , with DNP induced by intraperitoneal injection of streptozocin (STZ) 50 mg/kg (successful induction of diabetes was defined as blood glucose >16.7 mmol/L) , were randomly divided into 2 groups ( n=24 each) using a random number table:DNP group and dezocine group (group D) .Twenty-four normal rats were chosen and served as normal control group (group C) .In group D , dezocine 2.52 mg/kg was injected intramuscularly once a day for 7 consecutive days starting from 2nd week after STZ injection ,while the rats in DNP and C groups received the equal volume of normal saline .Paw withdrawl threshold (PWT) to mechanical stimulation was measured before dezocine injection (T0 ) ,and on 1st ,3rd ,5th and 7th days after dezocine injection (T1-4 ) and on 7th day after the end of dezocine injection (T5 ) .Twelve rats in each group were sacrificed after measurement of PWT at T4 ,and T5 .The lumbar segments of the spinal cord were removed for determination of NR2B protein expression (by immuno-histochemistry and Western blot ) and NR2B mRNA expression (by RT-PCR ) in the spinal dorsal horns .Results Compared with group C ,the PWT at T0-5 in group DNP and at T0 and T5 in group D was significantly decreased , and the expression of NR2B protein and mRNA at T4 ,5 in DNP group and at T5 in D group was up-regulated ( P<0.05) .Compared with group DNP ,the PWT was significantly increased at T1-4 ,the expression of NR2B protein and mRNA was down-regulated at T4 ( P<0.05) ,and no significant changes were found in the parameters mentioned above at T5 in group D ( P>0.05) . The PWT was significantly lower at T0 and T5 ,and the expression of NR2B protein and mRNA was higher at T5 than at T4 in group D ( P<0.05 ) .Conclusion Dezocine can effectively relieve DNP in rats and inhibition of NR2B expression in the spinal dorsal horns is involved in the mechanism .

Objective Currently, there are few articles about kinesiophobia in patients with total knee arthroplasty (TKA) in China.This study aims to investigate the incidence of kinesiophobia and its influencing factors in TKA patient, and provide evidence for the intervention of kinesiophobia.Methods A total of 298 TKA patients from our hospital were investigated by general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scales, Simplified Coping Style Questionnaire and Social Support Rating Scale.Single-factor analysis and logistic regression analysis were conducted to explore influencing factors.Results The score of TSK was 38.50±13.52, and 31.88% of TKA patients reported kinesiophobia.Logistic regression analysis showed that duration of pain (OR=5.546, 95%CI: 2.143-14.353), education level (OR=0.145, 95%CI: 0.067-0.314), self efficacy(OR=0.606, 95%CI: 0.470-0.780), positive response (OR=0.784, 95%CI: 0.683-0.900), objective support (OR=0.807, 95%CI: 0.691-0.943) and utilization of social support (OR=0.507, 95%CI: 0.461-0.705) were factors influencing kinesiophobia in TKA patients.Conclusion Attention should be paid to the kinesiophobia in TKA patients, especially those influencing factors including duration of pain, education level, and objective support.Health care providers should encourage early stage rehabilitation exercise to improve the postoperative knee function of TKA patients.