What characterized post-thoracotomy pain is that companied by marked decrease in pulmonary function,which negatively affect rehabilitation of the patients.In this paper,the author reviewed the effects of clinically common used therapies on pain relief and pulmonary function in patient after thoracotomy.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytosis, Sinus ; pathology ; surgery ; Humans ; Immunoglobulin G ; blood ; Paranasal Sinus Diseases ; pathology ; surgery ; Paranasal Sinuses ; pathology ; S100 Proteins ; metabolism ; Sclerosis ; pathology

To investigate risk factors and efficacy of reoperation for neovascular glaucoma ( NVG) secondary to vitrectomy in proliferative diabetic retinopathy (PDR).
●METHODS:Seven cases (7 eyes) from October, 2009 to December, 2012 were analyzed retrospectively. All the patients had NVG after the primary vitrectomy for PDR and were performed secondary vitrectomy combined with laser photocoagulation .
●RESULTS: The mean intraocular pressure ( lOP) was (11. 21±4. 22)mmHg before primary surgery. The number of laser spots ranged from 622 to 1124 during the first vitrectomy. Cataract extraction was performed in all 7 cases and intraocular lens was implanted in 5 cases. The mean lOP was (10. 11± 3. 62) mmHg during 2mo after the primary surgery. During follow- up, all the patients had significantly progressive intraocular inflammation. Vitreous hemorrhage was not absorbed completely in 2 cases and recurrent vitreous hemorrhage occurred in the other 5 cases. Five cases had poor glycemic control and the other 2 cases had bad blood pressure control. NVG occurred in all 7cases. The mean lOP was (41. 13 ± 7. 76) mmHg before the secondary surgery. After the secondary surgery, the lOP were under control in 5 cases. For the other 2 cases, the lOP was controlled in one case by transscleral cyclophotocoagulation, another one was lost in follow-up with uncontrolled lOP.
●CONCLUSlON: Primary vitrectomy combined with lens extraction, insufficient laser speckle, unabsorbed and recurrent vitreous hemorrhage, intraocular inflammation and systemic condition may be the risk factors associated with the occurrent of NVG after vitrectomy in PDR. Secondary vitrectomy combined with sufficient retinal photocoagulation is efficiency for NVG after vitrectomy for the PDR.

Objective To investigate clinical feature, diagnosis and treatment of tuberculosis infection in renal transplant patients. Methods To analyze clinical data of 13 patients suffering from tuberculosis infection after renal transplantation retrospectively. Results Twelve patients got lung tuberculosis while only one lymphoid tuberculosis. They were unequivocally diagnosed as tuberculosis by radiological plain film, searching acid-fast bacilli in sputum repeatedly, detecting DNA of Bacillus tuberculosis by PCR and biopsy, 4 of whom had mixed infection in lung. Eleven patients recovered after standard antituberculosis therapy, but 2 died. Hepatic function lesion was main adverse reaction in treatment, but it could get normal after adjustment of immunodepressant. Conclusion Tuberculosis incidence rate in renal transplant patients increased obviously. Standard antituberculosis therapy is effective, but immunodepressant should be adjusted in time according to the change of hepatic function and renal function.

After the advantages of PACS system in medical imaging examination were described, its rational appli-cation in medical imaging examination was elaborated .

Objective To compare the analgesic and side effects of tramadol, buprenorphine and morphine in equipotent dosage in patient-controlled intravenous analgesia (PCIA). Methods 53 patients (ASA I-II) scheduled for upper abdominal surgery were randomly allocated to receive 10mg/ml tramadol (group T) or 0.03mg/ml buprenorphine (group B) or 1mg/ml morphine (group M) plus 0.1mg/ml droperidol. Baxter APII PCA pump was used to administer the different analgesic according to the model of LCP, with the amount of loading dose, continuous infusion and bolus of 2.5ml, 0.5ml/h, 1ml respectively. At 4, 8, 16 and 24h postoperatively, pain scores in VAS, comfort scale in BCS, sedation scores with Ramsay score, and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. Drug consumption in the first 24h and the D/D ratio (demand/deliver) were also recorded. Results VAS and BCS scores showed no significant difference among the 3 groups, but drug consumption within the first 24h and the D/D ratio in group T were higher than those in other 2 groups (P0.05). 8 patients in group T, 5 in group B and 4 in group M suffered from nausea; 1 patient in group T, 2 in group B and 3 in group M complained of pruritus. No respiratory depression was observed in all cases. Conclusion Tramadol and buprenorphine can be safely used as PCIA in patients undergoing upper abdominal surgery, but they are not superior to morphine.

40), the values of BIS, electromyogram (EMG), signal quality index (SQI), mean arterial pressure(MAP), and heart rate(HR) were recorded every minute for 5min, then additional vecuronium (0.05mg/kg) was administered, and the values of the parameters above mentioned were registered for the next 10min. Results BIS value decreased significantly 3 min after the administration of the additional vecuronium (P0.05). Conclusion A misleading BIS value may be caused by the decline of muscle relaxant during the maintenance stage of propofol/fentanyl anesthesia, which greatly influence the accuracy of BIS monitoring.

0.7?g/L (n=18) and group 2 ≤0.7?g/L (n=18). Propofol concentration, BIS, and AAI were compared between the two groups. Results The patients in group 2 had a significantly higher propofol concentration in plasma (2.70 mg/L) on awakening compared with that of the group 1 (2.08 mg/L) (P

Objective To analyze the clinical features of pure red cell aplasia (PRCA),and to improve the recognition of its pathogenesis and treatment.Methods Among 35 PRCA patients from 1990-01 to 2003-04 in our hospital,17 patients(group Ⅰ) had immunologic abnormality,and the other 18 patients (group Ⅱ)were normal at every immunologic index.Removed the primary affection,all patients were given the combine treatment with drugs:androgen,immunosuppressive agent or/ and glucocorticoid.Results Nine patients in group Ⅰ appeared T subgroup ratio inversion in peripheral blood,eleven patients had higher level than normal with TNF?,and six patients' IL-2 level was higher.The response was 70.6%.Some patients shifted to normal in immunologic index.The response was 86.7% in group Ⅱ.But 11 cases relapsed of the 25 cured and remission patients.They responded again to the initial therapy.Conclusion Dysimmunity is the most important pathogenesis in PRCA patients.Most patients respond to immunosuppression therapy.The relapse patients also respond to initial therapy.

Objective To compare the analgesic effect, adverse effects of patient-controlled epidural analgesia (PCEA) vs patient-controlled intravenous analgesia (PCIA) and their influences on stress response in thoracotomy patients. Methods 33 ASA I-II patients undergoing elective esophagectomy were randomly assigned to receive either morphine plus droperidol (Group PCIA, n=17) or morphine plus bupivacaine (Group PCEA, n=16) for 3 days postoperatively. Serum concentrations of cortisol, angiotensin Ⅱ (Ang Ⅱ), endothelin (ET) and blood glucose were measured before operation, at the end of the operation and on the next morning after operation. Pain scores with visual analogue scale (VAS) at rest, deep breathing and with cough, and adverse effects were also recorded. Results Blood glucose and cortisol were increased to similar levels in both groups at the end of the operation, but were much lower in Group PCEA postoperatively (P0.05). Pain scores with VAS were much lower in Group PCEA, especially when the patient was at deep breathing or during coughing (P