Objective To analyze clinical and CT manifestations of mediastinal type lung cancer,in order to improve the under-standing of its CT signs.Methods 12 cases with mediastinal type lung cancer proved by pathology were analyzed retrospectively.Re-sults The mediastinal type lung cancer can be classified as central type (6 cases),peripheral type (4 cases)and hiding type (2 cases).There were 5 cases in the right upper lung,4 cases in the left lung and 3 cases in the lower lobe of right lung.CT showed irregular soft tissue masses adjacent mediastinum with size of 3-10 cm.7 cases showed homogeneous density and 5 cases showed heterogeneous density.The tumor and lung tissue interface was blurred in 8 cases and clear in 4 cases.5 cases had atelectasis.6 cases showed mediastinal lymph nodes enlargment.Conclusion Mediastinal type lung cancer has relatively specific clinical and CT manifestations;it can help to dif-ferential diagnosis with mediastinal tumors to understand these signs.

OBJECTIVE:To observe clinical effect and safety of temozolomide (TMZ) combined with radiotherapy in the treatment of malignant glioma. METHODS:58 patients with malignant glioma were randomly divided into TMZ-RT group(32 cas-es)and RT group(26 cases). RT group were given the therapy of 3D-CRT 1.8-3 Gy/d,and some patients received the hyperfrac-tion radiotherapy with total dose of 60-75 Gy. TMZ-RT group were given TMZ chemotherapy 75 mg/(m2·d)combined with radio-therapy for 6 weeks and TMZ sequential therapy 150-200 mg/(m2·d)for 4 weeks. Therapeutic efficacy and ADR were observed in 2 groups. RESULTS:After treatment,in TMZ-RT group,9 cases had complete remission,11 cases had partial remission,10 cas-es were stable and 2 cases were progressive;in RT group,6 cases had complete remission,8 cases had partial remission,8 cases were stable and 4 cases were progressive. There was no statistical significance in short-term efficacy between 2 groups(P>0.05). The 1,2,3-year survival rates of TMZ-RT group were 81.3%(26/32),78.1%(25/32) and 62.5%(20/32),while those of RT group were 84.6%(22/26),34.6%(9/26)and 15.4%(4/26). There were statistical significance in 2,3-year survival rates between 2 groups (P<0.05). Median recurrent time of TMZ-RT group was (23.2 ± 8.6) months,while that of RT group was (15.6 ± 8.7) months,with statistical significance(P<0.05). According to the KPS,TMZ-RT group was(89.6±9.6)and RT group(65.1±10.1), with statistical significance (P<0.01). The side effect of 2 groups were slight. CONCLUSIONS:Radiotherapy combined with TMZ can significantly improve the survival rates of 2 and 3-year and delay the tumor recurrent time,and lighter adverse reaction. It can be used as new therapy method for malignant glioma. But it needs further study for treating the malignant glioma patients with osteomyelitis or low immune function.

ObjectiveTo study the clinical significance of serum type Ⅳ collagen( Ⅳ - C) levelsfor the diagnosis of hepatic fibrosis. MethodsSerum levels of Ⅳ - C were measured in 209 patientswith viral hepatitis and 53 healthy persons by ELISA. ResultsCompared with the normal group,the serum Ⅳ - C level was significantly increased in patients with chronic moderate hepatitis and wasthe highest in patients with chronic severe hepatitis and hepatic cirrhosis( P < 0.01 ). There was no sig-nificant difference in the serum Ⅳ- C level among acute viral hepatitis, chronic mild hepatitis and con-trols ( P >0.05). There was significant difference in the serum Ⅳ - C level in patients with hepaticcirrhosis by Child- Pugh grading( P < 0.01 ). The serum Ⅳ - C level was positively correlated withthe degree of hepatic fibrosis and the severity of hepatic diseases. ConclusionThe meastrement of serumⅣ- C may be useful for assessment of the degree of hepatic fibrosis and progrosis of chronic hepatitis.

Objective To investigate the clinical application of dezocine and remifentanil in elderly patients with painless gastroscopy.Methods According to random number table,180 elderly patients undergoing painless gas-troscopy were randomly divided into dezocine group(group D),remifentanil group(group R)and control group(group C),each group 60 cases.Group D was infusion with dezocine 20μg/kg,Group R was infusion with remifentanil 0.5μg/kg and Group C was infused with normal saline,then three groups patients,respectively,after the interval of 1 minutes were given propofol 1 mg/kg.Objects induced sum of propofol,starting time,awakening time,discharged time,HR,MAP and SpO2 during operation,sedation scores,postoperative side effects such as nausea and vomiting were observed.Results The decrease of MAP was alleviated in group D compared with group C and group S(tDR =2.278,PDR<0.05 and tDC =2.545,PDC <0.05).SpO2 in group C and group R were significantly lower than that in group D(tDR=2.184,PDR<0.05 and tDC =2.206,PDC <0.05).The time for regaining consciousness(tDC =5.401 and tRC =6.674)and propofol dosage(tDC =3.726 and tRC=4.213)in group D and group R were significantly lower than those in group C(P<0.05).The Ramsay of group D was (2.3 ±0.7)points,which was lower than (3.8 ±1.2) points of group C,(3.6 ±0.9)points of group R(tDC =8.938,PDC <0.01;tDR=7.154,PDR<0.01),and there were fewer adverse reactions in group D.Conclusion Dezocine is more suitable for the elderly patients than remifentanil, which has exact effect of anesthesia,less respiratory depression,higher level of consciousness awakening and fewer adverse reactions.

OBJECTIVE To study the clinical application and its advantage of cervical tongue-shaped flap in tracheal stoma after total laryngectomy.METHODS A tongue-shaped flap was retained underneath the U-shape incision in front of the neck.When tracheal stoma was made,the tongue-shaped flap was sutured with the mucous membrane of tracheal posterior wall.A little bit tissue of tracheal anterior wall in the broken end could be cut off and sutured with the skin under the tracheal stoma.RESULTS The diameter of the tracheal stoma was or not less than 3.0 cm?2.5 cm after operation.All the cases were followed up for 1 to 4.5 years after surgery.The tracheal stoma of all the cases grown downwards to 2.0～1.8 cm after a half to one year and then maintained invariably.The tongue-shaped flap and the skin around the tracheal stoma maintained smooth.It was not necessary for the patients to wear the trachea cannulas.CONCLUSION This method has lots of advantages such as less pain,lower medical cost and the increased recovery rate.

Objective To investigate the risk factors of incidence of hypertensive disorder complicating pregnancy(HDCP)and provide reference for prevention and treatment of HDCP.Methods The clinical information of 2 217 cases of maternal delivery were retrospectively analyzed;The relevant social factors and obstetric factors of HDCP were analyzed.Results 186 cases of HDCP occurred in 2 217 cases of maternal,the incidence rate of HDCP was 8.4%.The single-factor analysis showed that the place of residence.prenatal system checks and parity had certain degree of contact with incidence of HDCP(χ2=11.2331,10.6781,5.4456,all P＜0.05),and the age,abortion history and parity had no significant correlation with incidence of HDCP(χ2=4.9201,3.0134,1.7301,all P＞0.05).Multivariate Logistic regression analysis showed that the rural living and no prenatal system check were risk factors of incidence of HDCP.Conclusion The maternal of rural living and no prenatal system check were the high-risk population of HDCP,and emphasis assessment and reasonable control these factors could reduce the incidence of HDCP.

Objective To evaluate the risk factors for cerebral infarction (CI) resulting from transient ischemic attack (TIA).Methods The clinical data of 133 patients with TIA were evaluated.The condition of CI happening was recorded.Seizure frequency,seizure duration,onset to treatment time,the number of seizure before treatment time,blood pressure,fasting blood glucose,total cholesterol,triglyceride and other factors were collected.The clinical data of TIA with CI and without CI were evaluated.Results Among the 133 patients,there were 48 patients suffering from CI (36.09％).Among 108 patients with TIA in the anterior circulation system,there were 39 patients (36.11％) suffering from CI.Among 20 patients with TIA in the posterior circulation system,there were 7 patients (35.00％) suffering from CI.There was no significant difference in the rate of CI between TIA in the anterior circulation system and TIA in the posterior circulation system (P ＞ 0.05).Among 5 patients with TIA in both the anterior and posterior circulation systems,there were 2 patients suffering from CI.In patients of TIA with seizure frequency ＞ 3 times/d,seizure duration ＞ 30 min,onset to treatment time ＞ 24 h or the number of seizure before treatment ＞5 times,the incidence of CI was significantly higher,and the difference was statistically significant (P ＜ 0.05 or ＜0.01).The onset to treatment time,systolic pressure,diastolic pressure,fasting blood glucose,total cholesterol and triglyceride levels in TIA with CI were significantly higher than those in TIA without CI (P＜0.05).Conclusion There is highly danger for patients to develop CI if patients with TIA has longer seizure duration,much more seizure frequency,longer onset to treatment time,especially those accompany with high blood pressure,hyperglycaemia and hyperlipoidemia.

Objective: To compare postoperative recovery situation between laparoscopic radical resection and conventional open surgery for patients with colorectal cancer and determine the optimal surgery scheme. Methods: 96 patients with colorectal cancer were divided into observation group (48 cases)and control group (48 cases) according to the random number table method. The patients of observation group were treated by using laparoscopic radical resection while the patients of control group were treated by conventional open surgery. A series of clinical manifestation, such as perioperative situation, abdominal pain, recovery situation, complication, pre-and post operative nutrition and quality of life, of these patients were compared between the two groups. Results: The operation time, average bleeding volume, postoperative exhaust time and hospitalization time of the observation group were significantly less than those of the control group (t=5.583, t=48.934, t=7.347, t=4.862; P<0.05). The incidence of abdominal complication of observation group (8.3%) was significantly lower than that of the control group (27.1%) (x2=5.79, P<0.05). The incidence of delayed healing of incision was 6.3% in observation group, which was significantly lower than that (20.8%) of control group (x2=4.36, P<0.05). For observation group or control group, the serum ALB, PA and LC of post-operation, respectively, was higher than those of pre-operation in 1 week after operation. And serum ALB, PA and LC of observation group, respectively, was significantly higher than that of control group (t=4.628, t=3.642, t=3.412; P<0.05). Compared with before operation, physical function, role function, emotional function, cognitive function and social functionthe quality of life of the two group were obviously improved, on the other hand, all of these aspects of the observation group were significantly higher than those of the control group (t=-12.845, t=-7.634, t=0.5001, t=-4.096, t=-2.647, P<0.05). Conclusion: Compared with the traditional open surgery for patients with colorectal cancer, the postoperative recovery of laparoscopic radical resection is better, more obvious and more effective for them.

AIM: To investigate the effects of Chlamydia pneumoniae infection and hyperlipidemia on the expression of NF-?B and AP-1 in the myocardium. METHODS: The indirect immunofluorescence method was used to examine wild C57BL/6J mice infected with Chlamydia pneumoniae and fed with an atherogenic diet. The expression of the subunit of NF-?B, P50, and c-Fos in the murine myocardium was observed. RESULTS: Chlamydia pneumoniae infection and hyperlipidemia induced the activation of NF-?B and AP-1 in murine myocardium. P50 and c-Fos were not detected in the controls, but there were different levels of positive expression in the experiments (P

Objective To discuss the way and effect of washing intestine and pelvic cavity to prevent the fistula of lo place close entrance's in carcinoma of rectum. Methods Cut the rectum and lymph node,used the tip large intestine to connect with washing machine tube. cut vermiform appendix and put urine tube enter ileocecal them use 500ml N.S to wash large intestine for sustained.After se the recturn and large intestine.Use two tube(0.8～1cm) pelvic cavity about 1～6 days. Results The improvement group(38 cases) had not occur leak of lo place cclose entrance, classical group (18 cases) had occur 2 cases (11.1%)leak of lo place close entrance, usestatistics to deal with, P