Objective To evaluate the long-term curative effect of bronchial artery embolization on massive hemoptysis in patients with pulmonary tuberculosis. Methods Bronchial arterial embolization with PVA grain and silk segment was performed in 42 cases of patients with hemoptysis of secondary pulmonary tuberculosis. Of them, 27 cases were bilateral pulmonary tuberculosis and 15 lateralized. The bloody bronchial arteries were confirmed by bronchial arteriography, and the PVA grains or silk segments were injected slowly into the target vessels until hemorrhage stopped. Results After one time embolization, hemoptysis stopped immediately in 34 cases, 7 cases still had little hemoptysis,and one case of hemorrhage was unable to be controlled. The short-term efficacious rate was 97.6%,and no severe complications occurred. Followed up 6 months to 7 years after treatment,24 cases were clinical cure,7 cases obviously effective,5 cases effective,and 6 cases recurrent.The long-term effective rate is 85.7%. Conclusion Embolization of bronchial artery with PVA grain and silk segment was a safe and effective method for controlling hemoptysis of pulmonary tuberculosis, and its combination with anti-tuberculosis treatment could consolidate the curative effect.

Objective The purpose of this study was to examine the status quo of the perceptions of professional benefits in the clinical teachers of nursing,analyze the influencing factors and put forward effective measures to improve it.Methods A convenience sample of 117 nurse preceptors in 4 teaching hospitals participated by completing a two-part questionnaire the Preceptor's Perception of Benefits and Rewards Scale and a demographic questionnaire.Results The total average score of benefits and rewards to the preceptor role was(63.64±9.93) points,low than the study done by Hyrkas(2007) in American.Nurse preceptors in different nursing unit felt different benefits and rewards to the preceptor role.Medicine unit and surgical unit were higher than Pediatrics unit.The longer time of being preceptor,the higher score of benefits and rewards to the preceptor role.Conclusions The score of benefits and rewards to the preceptor role is low.Hospitals should increase support for clinical teaching program,particularly pediatrics.Nurse managers should adjust promotion opportunities,workload,rewards of nurse preceptors to meet the needs of nurses in clinical teaching and to improve teaching effectiveness.

Bronchoscopy is a minimally invasive method for obtaining peripheral pulmonary lesions (PPL). Traditional bronchoscopy-guided transbronchial lung biopsy (TBLB) is performed under X-ray guidance, and diagnostic rate is relatively low. A new, real-time electromagnetic navigation bronchoscopy (ENB) is a minimally invasive diagnostic technique which appeared in recent years. Studies suggest ENB is a feasible and safe method for diagnosis of PPL which shows higher diagnostic yields than traditional TBLB, and its potential application in localization and treatment of PPL. This article reviews the clinical application of the technique.

Objective　To investigate the possible roles of the different subnuclei of hypothalamic paraventricular nucleus （PNV） which may regulate splenic immune function. Methods　4 SD rats received splenic injection of pseudorabies virus（PRV）.96 hours after injection， a block containing hypothalamus was taken and cut into 40 μm sections with cryostat. Immunohistochemical technique and stereology method were used to detect the distributing character of transsynaptic PRV infection neurons in the PVN and the localization relationship between PRV neurons and AVP neurons in the PVN.Results　Transsynaptic PRV infection neurons distributed through out the PVN， but mainly concentrated in the lateral parvocellular （LP） subnucleus of PVN and posterior magnocellular （PM） subnuclei of PVN （occupied 73.49％ of total surface area），a few distributed in the anterior， dorsal and periventricular parvocellular （AP，DP and PP）nuclei of PVN，few scatted in the rest of nuclei of PVN. In the LP and PM some of the PRV neurons distributed among the AVP neurons.Conclusions　Besides the classical neuro-immuno-endocrine modulation， the PVN may regulate the splenic immune function through direct innervation .The AVP neurons in the PM and neurons projecting to the proganglionic neurons in the dorsal medulla and lateral horn of spinal cord in the LP，DP and AP regulate the immune function of spleen through sympathetic and para-sympathetic innovation.

Atrial fibrillation ( AF) is an abnormal heart rhythm characterised by rapid and irregular beating.It is caused by multiple factors and can lead to ischemia-associated thrombosis, heart failure and other complex symptoms. Based on the etiology and characteristics of AF, animal models have 3 main categories including electrical, neurohormonal or vessel-related, and structural remodeling models.New technologies such as microRNA knock-down/overexpression or CRISPR-Cas9 gene editing provide tools for constructing animal AF models and directions in the development of AF thera-peutic strategies.Currently these strategies have largely focused on the cellular and molecular therapeutics rather than tradi-tional invasive electrophysiological methods or antiarrhythmic drugs.With the aid of new tools, progress has been greatly made in a broad range of therapeutic research areas including molecular mechanisms, drug targeting and screening.This re-view summarizes the animal models of atrial fibrillation currently used in studies of the molecular and cellular therapeutics and notes their contributions to this research area.

Objective To explore the technique and clinical effect of Fogarty catheter in treatment of acute limb arterial embol-ism.Methods Eight cases of acute limb arterial embolism treated by Fogarty catheter were analyzed retrospectively.The technique of thrombectomy,curative effect,complications,prognosis,and 6-24 months follow-up results were assessed to evaluate the safe-ty,effectiveness and operative skills.Results Seven cases were cured,and 1 case was efficacious.The endangium injury and vaso-spasm was occurred in 1 case,respectively.During follow-up from 6 to 24 months,6 cases recovered activity,1 case was hemiplegia because of cerebral infarction after 12 months,and 1 case died of respiratory function failure after 6 months.Conclusion Fogarty catheter is safe and effective in treatment of acute limb arterial embolism.

Objective To explore the value of intravenous low dose furosemide on visualization of upper urinary tract during CTU. Methods 39 cases of normal upper urinary samples were examined by CTU with 5 minutes delayed,19 cases underwent intravenous injection of furosemide.The upper urinary tract was divided into 5 parts for scoring of images on a 5 score scales for opacification,the average value of ureter short axis of distention,and CT value by contrast material were measured.Results were analyzed by t test using SPSS.Results (1)30/38 segments of upper urinary tract were all or almost all opacification in furosemide group,the scores of upper urinary tract were higher than that of the control group,which had significant difference except the pelvis and left proximal ureter segments. (2)The disention of the ureter was significantly higher for all segments in furosemide group.(3)CT values in furosemide group decreased significantly for all upper urinary tract.Conclusion CTU excretory phase image acquisition with intravenous low dose furosemide is helpful on visualization of upper urinary tract.

Objective To evaluate the interventional management in emergency splanchnic bleeding and the application value.Methods 27 patients with emergency splanchnic bleeding underwent the interventional management in our hospital from May of 2003 to January of 2006 were reviewed.The sites and causes of the splanchnic hemorrhage were verified through selective DSA,using different methods and materials for percutaneous transarterial embolization.Results No bleedings recurred in all 27 patients within 18 months after the treatment.3 patients of advanced hepatic carcinoma died in 6 months because of non-splanchnic bleeding etiology.Conclusions Selective angiography is a veracious way to detect the location and cause of emergency splanchnic hemorrhage.The choice of different selective arterial embolizations and embolic materials can effectively and promptly cease the bleeding with rescuing the patients.

Objective To evaluate early diagnostic and guiding therapeutic value of MRI in children’s acute supparative osteomyelitis.Methods The axis,sagittal and coronal planes were performed with Philips 0.5 T superconduct MR scanner in 16 cases with acute suppurative osteomyelitis of lower extremity 2 to 14 days after onset.Results Abnormal signals in marrow were displayed in all 15 cases 3 to 14 days after onset. No abnormality was found in 1 case 2 days after onset. The interface between nomal and abnormal marrow became clear as time going on. The lesion presented as patchy low intensity on T 1WI and high signal on T 2WI. The signal changes were marked especially on STIR. Acording to MR imaging, all cases were divided into abscess type and non-abscess type.Abscess were operated and non-abscess were not. The mean follow up was 1 year, cure rate was 100%.Conclusion MRI is of significant value in early diagnosis and guiding therapy of acute suppurative osteomyelitis.

Objective To discuss the safety and clinical effect of fine needle single-step centesis in percutaneous endoscopic nephrolithotomy for renal staghorn calculi. Methods Percutaneous endoscopic nephrolithotomy with fine needle single-step centesis was employed in 75 patients (single-step group) with renal staghorn calculi, and percutaneous endoscopic nephrolithotomy with two-step centesis was adopted in other 75 patients with renal staghorn calculi (two-step group). The clinical effect and the incidence of complications were compared between the two groups. Results The placement of drainage catheter was successfully accomplished in all 150 patients. In single-step group the operation time was 18-45 minutes with a mean of 36 minutes; the mean blood loss during the procedure was about 5 ml. After the treatment, massive bleeding occurred in 3 cases that needed blood transfusion, and residual stone was observed in 6 cases. In two-step group the operation time was 16-42 minutes with a mean of 34 minutes; the mean blood loss during the procedure was about 7 ml. After the treatment, massive bleeding occurred in 7 cases that needed blood transfusion; one of them had renal pseudoaneurysm and the bleeding was stopped after renal artery embolization treatment; and residual stone was observed in 7 cases. No procedure-related perirenal organ injury was seen in single-step group, while in two-step group pneumothorax (n=1) and injury of splenic flexure of colon (n=1)were found. Conclusion In performing percutaneous endoscopic nephrolithotomy, fine needle single-step centesis is more safe and effective than conventional two-step centesis.