Objective To investigate the feasibility of mini-incision muscle-sparing thoracotomy for pulmonary diseases. Methods The operation was performed through a subaxillary mini-incision along the 5th,6th,or 7th intercostals space and 8.5~13.5 cm in length.The latissimus dorsi muscle was pressed backwards,and the serratus anterior muscle was opened along the direction of muscle fibres.The intercostal muscles and the pleura were cut through along the midline between the two adjacent ribs or the superior border of the rib,for the resection of pulmonary benign or malignant lesions.Results The operation was successfully accomplished via mini-incision thoracotomy in all the 38 cases,including 17 cases of wedge resection,1 case of lesion resection of pulmonary sequestration,18 cases of lobectomy,1 case of lower right lobectomy,and 1 case of left total pneumonectomy.The duration of procedure was 50~150 min(mean,96 min),and the intraoperative blood loss was 100~400 ml(mean,220 ml).No complications were seen.Pleural effusion developed in 1 case postoperatively,and then subsided after drawing-off of fluid.Conclusions The mini-incision muscle-sparing thoracotomy has advantages of clear exposure and minimal invasion.But this procedure is not advisable in patients scheduled for a re-operation or with extensive pleural adhesion or tumor involvement to the chest wall.

Objective To observe the efficacy and effect on cerebral vascular reserve and serum hs-CRP of Xueshuantong combined with butylphthalide in patients with acute cerebral infarction.Methods A total of 140 cases with ACI in Huzhou Central Hospital from August 2015 to July 2016 were divided into the observation group and the control group with 70 cases in each group, according to the order of single and double number.The control group was treated with routine western medicine while giving butylphthalide , and the observation group was given Xueshuantong on the basis of the control group.After two weeks of treatment, the efficacy and CVR, BHI and hs-CRP levels were observed.Results After treatment, the total effective rate of the observation group was 92.86%, and the control group was 81.43%, the difference was statistically significant (χ2 =4.080, P<0.05), there was significant differences of CVR, BHI between two groups (Fgroup =5.534, 4.608, P<0.05), the CVR and BHI increased gradually with time (Ftime =11.325, 9.432, P<0.05), the rised amplitude in observation group was higher than the control group (Finteraction =5.742, 5.016, P<0.05), there were significant differences in the levels of hs-CRP between two groups (Fgroup =7.421, P<0.05), and hs-CRP decreased gradually with time (Ftime =10.185, P<0.05), the decrease of observation group was larger than that of control group(Finteraction =4.824, P<0.05).Conclusion Xueshitong combined with butylphthalide in the treatment of ACI is effective , can better improve cerebral vascular reserve capacity and inhibition of inflammatory response, better than the single use of butylphthalide.

Objective To investigate the coping characters in patients with irritable bowel syndrome(IBS) by measuring the scores of life events, characteristic copings and coping styles. Methods Compared with those in health controls and peptic ulcer(PU) patients, Life Event Scale and Coping Style Questionnaire were used to evaluate 41 consecutive patients with IBS. Results IBS had a higher score of negative life events (43.92? 5.75 )than health controls (23.45?2.73, P =0.025) and PU(25.43?2.98, P =0.035). IBS also had a higher score of negative coping styles(40.79?8.01) than health controls (35.52?7.60, P =0.010) and PU(36.41?8.41, P =0.045). There was significant difference between IBS and health controls in the coping styles for fancying and withdrawal( P

Objective To study the changes of cytokines in aqueous humor of patients with proliferative diabetic retinopathy (PDR)after intravitreal bevacizumab (IVB) and the correlation of these cytokines.Methods Fifty-six patients(63 eyes) with severe PDR underwent pars piana vitrectomy (PPV) with IVB pretreatment in our hospital from April,2014 to February,2015 were collected.All the patients received IVB therapy from 3 days to 7 days before PPV.Aqueous humor samples were collected at the time of IVB and PPV treatment.The concentrations of vascular endothelial growth factor (VEGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) were measured by cytoinetric bead array (CBA).The changes of these cyto-kines after IVB were analyzed by using Wilcoxon rank sum test for paired data.The correlation between these cytokines was analyzed by using Spearman rank test.Results From 3 days to 7 days after IVB,the concentration of VEGF in aqueous humor was (6.57 ± 12.29)pg · mL-1,lower than the pre-operation of (278.71 ±340.20)pg · mL-1,the difference was statistically significant (P ＜ 0.05).The concentration of IL-8 was (385.60 ± 1099.47) pg · mL-1,higher than pre-operation of(298.87 ± 1005.79) pg ·mL-1,the difference was statistically significant (P ＜ 0.05).IL-6 and MCP-1 were increased after IVB,but the difference was not statistically significant (all P ＞ 0.05).VEGF,IL-6,IL-8 and MCP-1 had an obviously relationship between each two factors(all P ＜ 0.05).Conclusion Angiogenesis in patients with PDR are regulated by a variety of cytokines,and targeted reduction of VEGF may compensatory increase the concentration of other inflammatory cytokines.

This article analyzes the factors of influencing practice quality from such aspects as hospital management,medical reform,clinical teachers and students and points out that only by enhancing the management of practice hospital as well as the system of examining and assessment,raising the teacher guidance and teaching consciousness and guiding the students to properly handle with the relations between employment,entrance exam for postgraduate and practice can we guarantee the clinical practice quality.

Objective To explore the gene sequencing and prenatal diagnosis of Glanzmann thrombasthenia (GT). Methods The blood samples were drawn from one case of phenotype GT pediatric patient, patient’s parents, and one normal control. The amniotic lfuid and cord blood from the fetus of patient’s mother were collected. When the fetus was born 2 days, the blood was drawn. The coagulation routine test and platelet aggregation test were performed. The expression of platelet membrane glycoprotein (GP) IIb and GPIIIa were tested by lfow cytometry. Microsatellite technology is used to determine whether fetal cord blood is contaminated with maternal cells. The expressed region and the junctional zone between exon and introns of GPIIb and GPIIIa were ampliifed by PCR technology from blood sample of patient, patient’s parents, and fetus’s cord and 2 days after birth. The PCR products were then subjected to DNA sequencing. Results Adenosine diphosphate (ADP) cannot induce the platelet aggregation in the patient. The max rate of the platelet aggregation in the fetus’s cord blood was half of the normal. However, the max aggregation rate induced by ADP in the blood sample of parents and fetus 2 days after birth were equal to normal. The mean lfuorescence intensity (MnX) of platelet membrane GPIIb and GPIIIa in the patient were 10%and nearly zero of the normal control, respectively, while those in the parents, the fetus’s cord blood and 2 days after birth were more than 90%and 30%to 50%of the normal control. The cast-off cells in amniotic lfuid and the DNA in cord blood analysis by microsatellite technology conifrmed that the amniotic lfuid and cord blood not contaminated by maternal cells. Gene analysis showed the heterozygosis mutation in exon6 A3829→C and exon9 G42186→A of the patient’s GPIIIa led to the amino acid heterozygosis mutation in GPIIIaHis281→Tyr and Cys400→Pro. These two mutations came from the father and the mother separately. However, there was only one heterozygosis mutation in exon9 G42186→A in the cast-off cells in amniotic lfuid, the fetus’s cord and blood 2 days after birth. Conclusion This GT patient have double heterozygosis mutation. The fetus has heterozygosis mutation conifrmed after birth.

Insulin resistant rats induced by fructose were treated with rosiglitazone (RSG), and the effect of RSG on the endocrine function of vascular endothelial cells were investigated. The results showed that RSG can improve the endocrine function of endothelia by enhancing aortic NO synthase activity and the ability of anti-oxidative stress.

Objective To analyze and compare two potency assay methods of protamine sulfate.Methods Heparin titration method was according to foreign pharmacopoeia,while biological assay method was according to China pharmacopoeia(2015).Results The absorbance at the end-point was stable at 0.10 mg/mL and 0.15 mg/mL test solutions.The relative standard deviations(RSDs)of potency results were all less than 5%.Three test solutions and volumes of the titrant had a good linear relationship(R2 =1.000).The results of titration method were significantly related to those of biological assay(P=0.013),with similar RSD(P>0.05).However,the potency of titration method were significantly lower than those of biological assay (P=0.045).Conclusion Heparin titration method is good-using,convenient,and need to be applied widely at home.

Objective To provide an experimental reference for clinic application of Jiazhu vascular ligating clips on ligation effects and the impact on the body in rabbits after laparoscopoic cholecystectomy.Methods 36 rabbits were randomly divided into 3 groups, normal control group, Jiazhu group and similar product control ( Hem-o-lok) group, 12 rabbits in each group.Except for normal control group, the rabbits were used gallbladder duct and gallbladder artery closed by vascular ligating clips and Hem-o-lok clips in Jiazhu group and similar product control group, respectively.The changes of blood biochemical, electrolytes, hematological parameters, coagulation, ligation effects and organ coefficients were observed at post-operation during 12 months.Results Compared with normal control group, the rabbit weight was reduced in the Jiazhu group at 3 days postoperatively ( P <0.01 ) , ALT level was increased at 1week postoperatively ( P <0.05), CREA and ALB levels were all significant decreased at 1~2 weeks postoperatively (P <0.05, P <0.01), NEUT numbers and TG content were significant increased at 2 weeks postoperatively ( P <0.05 ) , GLU content was significant decreased at 2 weeks and 1 month postoperatively ( P <0.01 ); LYM and RBC numbers were significant decreased at 1 month and 1 week postoperatively (P <0.05), respectively.PLT numbers were significant increased at 1~2 weeks postoperatively ( P <0.01) .While the rabbit weight was reduced in the Hem-o-lok group between 3 days and 1month postoperatively (P <0.05, P <0.01), and ALT level, NEUT and PLT numbers were increased at 1 week postoperatively (P <0.05, P <0.01), ALB and GLU contents were all significant decreased at 2 weeks postoperatively (P <0.01), TC content was significant increased at 1~2 weeks postoperatively (P <0.05).The rabbit weight, blood biochemical and hematological parameters in the Jiazhu group and Hem-o-lok group were all no significant differences with normal control group in the remaining time ( P >0.05 ) , and there were all no significant differences with electrolyte, coagulation and organ coefficients between each group (P >0.05).Conclusion Jiazhu vascular ligating clips are safe and reliable to close gallbladder duct and blood vessels, It shows that there are no differences in the validity and security between Jiazhu vascular ligating clips and Hem-o-lok clips.

Objective To test the effectiveness of an integrated intervention to improve control and management of type 2 diabetic patients.Methods The study was designed as a randomized and multi-center clinic trial for 24 weeks.150 overweight patients from 2 companies and one hospital in Shanghai were recruited.The principal objective of the project was to compare the effectiveness of a structured diabetes management program consisting of 200 kcal breakfast as a meal replacement with low glycemic index (GI),scheduled blood glucose monitoring(6 times per week),low GI diet consulting,monitoring and medical check up and nutritional education (diet consulting,health education on nutrition and healthy lifestyle) in overweight individuals with type 2 diabetes.Results At 12th week,the level of fasting blood glucose(FBG) in both groups decreased by 16.5% and 10.6%,and at 24th week,the FBG also decreased by 25.0% in intervention group,but in control group FGB increased 2.8% (P＜0.01).Meanwhile,there were 8.2% and 11.1% reductions in HbA1C respectively at 12th week and at 24th week in intervention group,while the values were increased slightly in control group(P＜0.01).Compared with control group,waist circumference,hip circumference,and blood pressure were significantly reduced after treatment for 24 weeks in intervention group (P＜0.01).Conclusions Integrated intervention is an effective approach in managing FBG,HbA1C blood pressure,and weight control in overweight diabetic patients.