Objective To explore the reasonable clinical target volumes by analyzing the characteristic of mediastinal lymph node metastases in non-small-cell lung cacer (NSCLC).Methods 291 NSCLC patients was performed pre-therapy CT scans,and the incidence of mediastinal lymph node metastases was analysed.Results Among the 152 patients with right lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (24/152),and the incidence of involvement of the contralateral lymph nodes was 6.6 ％ (10/152).The highest incidence of mediastinal nodal involvement occurred in the ipsilateral hilar nodes (59.2 ％),followed by area 4R (56.6 ％),area 1-2R (36.2 ％),area 7 (33.6 ％),area 4L(20.4 ％),area 10-11L (5.9 ％),area 6 (3.9 ％),area 5 (2.0 ％),area 1-2L (2.0 ％),respectively.Among the 139 patients left lung NSCLC,the incidence of involvement of the ipsilateral supraclavicular lymph nodes was 15.8 ％ (23/139),and the incidence of involvement of the contralateral lymph nodes was 5.8 ％ (8/139).The highest incidence of mediastinal nodal involvement occurred also in the ipsilateral hilar nodes (54.0 ％),followed by area 7 (33.8 ％),area 4R (26.6 ％),area 4L (24.5 ％),area 1-2R (15.8 ％),area 5 (10.8 ％),area 6 (9.4 ％),area 1-2L (5.8 ％),area 10-11R (5.0 ％) respectively.Conclusion The right side primaries or left side primaries of NSCLC have different high risk lymph node areas for metastasis,and selective irradiation to these lymph node areas maybe increase the tumor control rate and reduce the recurrence rate.

Objective To investigate effect of respiratory training on respiratory function recovery following thoracotomy. Method Respiratory muscle training, productive drainage, exercise and respiratory function training, and appropriate rehabilitation were performed on 216 patients underwent thoracotomy. Result 206 patients showed favorable recovery of respiratory function,7 showed respiratory dysfunction, and 1 developed serious complication. Conclusion Respiratory training after thoracotomy significantly improve respiratory function.

Objective To investigate the delayed alteration of hippocampus proteome after an-esthesia with isoflurane in aduh and aged rats. Methods Ten 8-month-old SD rats were randomly divided into group Caduh and group Iadult (5 in each group) , and another ten 22-month-old SD rats were randomly divided into group Caged and group Iaged (5 in each group). The rats in group Iadult and group Iaged received 2 h anesthesia with 1.2 % isoflurane. The rats in group Cadult and group Caged inhaled 40% oxygen for contrast. The hippocampal proteome of each rat was measured by 2-dimensional gel electrophoresis and mass spectrometry. Results The vital signs of the rats in group Iadult and group Iaged were stable. There were 878±34 protein spots in group Cadult, 864±49 protein spots in group Iadult, 834±47 in group Caged, and 819±24 in group Iaged. There were 12 (4/8)different protein spots between group Iadult and group Cadult. There were 11 (3/8) different protein spots between group Iaged and group Caged. All of the protein spots were identified by MALDI-TOF-MS. Most of the different proteins were related to metabolism, anti-oxidation, and signal conditioning of synapse. Conclusion Isoflurane may cause the alteration of hippocampal pro-teome in rats, which is age-related.

ObjectiveTo investigate the effects of aliskiren on blood nitric oxide(NO) and bradykinin (BK) through analyzing the changes of NO, BK and non-dominant arm blood pressure before and after treatment of aliskiren and ramipril. MethodsThe chnical trial was conducted in 67 patients with essential hypertension. After a single-blind period of taking placebo orally once a day for 2 weeks, the patients were divided into different group in accordance with random table, and all patients were consecutively treated with drugs for 8 weeks. The trial uncovered showed that 17 patients were treated with ramipril (5 mg) in control group. Patients in trial group were given aliskiren and were assigned to three subgroups, 300 mg group (300 mg aliskiren, 16 cases), 150 mg group(150 mg aliskiren, 17 cases) and 75 mg group(75 mg aliskiren, 17 cases). The blood NO and BK before and after treatment in two groups were measured by enzyme linked immunosorbent assay and radioimmunoassay method. Non-dominant arm blood pressure was measured by calibration qualified mercury blood pressure instrument before and after treatment. Results The blood NO after treatment of aliskiren 8 weeks in trial group increased significantly than those before treatment [before treatment, the blood NO in 300 mg group, 150 mg group,75 mg group were (44.414 ±5.841 ), (43.496 ± 5.576), (41.037 ± 5.312) μ mol/L, after treatment they were(60.381 ± 6.756), (56.480 ±6.959), (53.766 ±7.276) μmol/L] (P <0.05). After treatment, non-dominant arm blood pressure decreased significantly in trial group (P < 0.05 ), but the blood BK had no significant defference before and after treatment (P >0.05). The blood NO and BK after treatment of ramipril 8 weeks in control group increased significantly than those before treatment [(57.286 ±6.431) μmol/L vs.(39.935 ±6.388)μ mol/L, (7.120 ± 1.015) μg/L vs.(5.232 ± 1.288) μg/L], and meanwhile non-dominant arm blood pressure decreased significantly(P <0.05). ConclusionsAliskiren and ramipril could increase the concentration of NO remarkably. Ramipril has strong effect in increasing the concentration of BK, but aliskiren hasn't effect on BK.

Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia.Methods Sixty children (1ys≤ age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV,n =20],group B [pressure control ventilation (PCV) + VCV,n =20] and group C (PCV + PCV,n =20) randomly.The P mean,Pmax,and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored.The SpO2,PaO2,and PaCO2 after mechanical ventilation 1.5 hours were recorded.Results Compared to group A,groups B and C had lower P max and P mean (P ＜ 0.05) during the FOB procedures.Compared to groups A and B,group C had a lower P max and P mean (P ＜0.01) after the FOB procedures.At the 1.5 hours after the procedure,all the children showed significant increase in SpO2 and PaO2 (P ＜ 0.05) and decrease in PaCO2 (P ＜ 0.05) in groups A,B,and C.Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia,the pressure control ventilation (VCV) mode can decrease the pressure of airway (Paw) and PaCO2 than volume control mode during procedure.

Objective To investigate and analyze of the distribution of herpes zoster in in-patients from 1995 to 2004.Methods The datas of in-patients with herpes zoster from 1995 to 2004 were statistically analyzed.Results There were 290 primary diseases,154 complications and 335 without underlying diseases.In-patients with herpes zoster were increasing year by year.The amount of severe patients over 60 years old were more than these of other old group.Conclusions The incidence of herpes zoster are rising year by year.There is high incidence and complications and more postherpetic neuralgia in old man and the people with immune disorder.So early diagnosis and treatment is an effective preventing and treating measure.

Objective To analyze the influencing factors of AVM bleeding for surgical treatment.Methods The 64 cases of bleeding AVM patients,clinical informations,condition of surgery and inspection of pathology were summarized.Results The prognosis was evaluated by Glasgow outcome scale(GOS)for every patient after the operation.36(53.3 %)recovered well,13(20.3 %)moderately disabled,4(6.4 %)severely disabled,and 11(17.3 %)died.Conclusions The effect of surgical treatment in patients with the age of onset,the site of hematoma,the bleeding volume and timing of surgery-related.The incidence between the ages of 8～14 years of age,the amount of bleeding

Objective To study the effects of TNF -?and sTNFRⅠon IL -8production and proliferatio n of psoriatic keratinocytes.Methods In vitro cultured keratinocytes were treated with TNF -?,sTNFRⅠand an-ti -TNFRⅠ.IL -8levels in supernatants were me asured by enzyme-linked immunosobent assay.Expression of IL -8mRNA in keratinocytes was observed by semiquantitive RT -PCR and Southern blotting.Proliferation index wa s measured by MTT colorimetry.Results IL -8levels,mRNA expression and pro liferation index were significantl y higher in psoriatic patients than th ose in control group(P

ObjectiveTo investigate the incidence and gene mutation spectrum of childhood thalassemia in Sanya city. MethodsThere were 938 children in our hospital screened by routine blood test, C-reactive protein test and hemoglobinelectro-phoresis. Based on the screening results in children with thalassemia and its subtypes, the alpha thalassaemia children were diag-nosed by gap - polymerase chain reaction, while the beta thalassaemia ones were diagnosed by polymerase chain reaction-reverse dot blot, and all the results were retrospectively analyzed.ResultsScreening positive rate of thalassemia anemia was 13.65% (128/938), genetic diagnosis positive rate was 11.41% (107/938). In 107 cases diagnosed with thalassemia by genetic test, 59 were alpha thalassaemia, and 46 were beta thalassaemia, and 2 cases were alpha thalassaemia combined with beta thalassaemia. In 59 cases of alpha thalassaemia, 31 had genotype of - SEA/alpha alpha , 13 cases with genotype alpha 4.2 / alpha alpha, and 6 were of HbH disease. In the 46 cases of beta thalassaemia children, six gene locus mutations were found : CD41-42 (CTTT) in 21 cases, TATAbox - 28 (A - G) in 13 cases, CDs14/15 (G) in 5 cases, IVS - Int 654 (C - > T) in 4 cases, CD17 (A - > T) in 2 cases, and 27-28 (C) in 1 case.ConclusionHigh prevalence of thalassemia in children from Sanya city warrants genetic counseling, premarital check-up and prenatal diagnosis.

ObjectiveTo investigate the effects of dexmedetomidine on postoperative cognitive function and monocytes Toll-like receptor 2 (TLR2)and TLR 4 expression in elderly patients.MethodsForty-five ASA Ⅰ or Ⅱ elderly patients aged ≥65 yr weighing 53-72 kg were randomly divided into 3 groups: control group (group Ⅰ ) and different doses of dexmedetomidine groups(groups Ⅱ and Ⅲ ).Dexmedetomidine 1.0 μg/kg was injected iv over 15 min after anesthesia induction,and then was infused at a rate of 0.5 μg·kg-1 ·h-1 (group Ⅱ ) or 1.0 μg· kg-1 ·h-1 (group Ⅲ ) untile the end of operation.Group Ⅰ received equal volume of normal saline.Blood samples were taken before anesthesia induction,at 1.5 h after the beginning of operation,at the end of operation and at 24 h after operation(T,-T5 ) for determination of monocytes TLR2 and TLR4 expression by flow cytometrybased method.Postoperative cognitive function was evaluated at 1 d before and 7 d after operation with Mini-mental state examination and Wechsler memory scale and Wechsler adult intelligence scale,and the postoperative cognitive dysfunction was recorded.ResultsThe incidence of postoperative cognitive dysfunction and monocytes TLR2 and TLR4 expression were significantly lower in groups Ⅱ and Ⅲ than in group Ⅰ,and in group Ⅲ than in group Ⅱ (P ＜ 0.05).ConclusionDexmedetomidine can prevent postoperative cognitive dysfunction in elderly patients,and the mechanism may be related to down-regulation of monocytes TLR2 and TLR4 expression.