Objective To discuss the treatment effect of well-differentiated thyroid carcinoma.Methods From 1992 to 2002,42 cases of well-differentiated thyroid carcinoma invading the laryngotrachea were treated in shanxi tumor hospital.Radical tumor resection were 6 cases,local shaving-off tumor resection were 32 cases and incomplete tumor resection were 4 cases.Some patients received postoperative radiotheraPy.Results In the 42patients,the overall 5-year survival rates were 76.2%(32/42).Conclusion Although well-differentiated thyroid carcinoma invaded the laryngotrachea,the operation can increase the curative effect and the patient's living standand.

Objective To investigate the roles of renin-angiotens in system(RAS)and aldosterone(ALD),endothelin(ET),nitricoxide(NO)in patients with renal hypertension(40 cases)and adrenocorticoadenomas(35 cases),35 normal subjects were included in the study as controls.Methods Radioimmunoassay(RIA)was used to de termine the plasma concentrations of the renin,angiorensin Ⅱ(AⅡ),aldosterone,ET in the abovecases.Enzymicas say was adopted to examine the plasma concentration of the nitricoxidesynthase(NOS).Results TIhe plasma concentrations of renin,angiotennsin Ⅱ,aldosterone,endothefin in the patients with renal hypertension were significantly higher than those in the control group(P＜0.01)except with the concentration of NOS,which were lower than that in controls(P＜0.05);the plasma concentrations of the ALD,ET,in the patients with adrenocorti-caladenoma were higher that those in controls(P＜0.01)but renin and A Ⅱ were lower(P＜0.05).Conclusion Determination of the plasma renin,angiotensionⅡ,aldosterone and NO might be able diagnose renal hypertension and adrenocorti coadenoma earlier.

Objective To investigate the diagnostic value of serum tumor markers carcinoembryonic antigen (CEA) ,neuron spe-cific enolase(NSE) ,cytokeratin-19 fragments(CYFRA21-1) ,squamous cell carcinoma antigen(SCCA)in the lung cancer .Methods By using electro chemiluminescence immunoassay ,the concentrations of CEA ,NSE ,CYFRA21-1 and SCCA were determined in 98 cases of lung cancer and 30 cases of healthy control group ,and the positive rate ,sensitivity ,specificity ,accuracy were calculated .Re-sults In different lung cancer pathological groups ,the concentrations of the 4 serum tumor markers were significantly higher than the control group(P<0 .05) .CEA had the highest diagnostic sensitivity for detecting adeno carcinoma ,NSE had the highest diag-nostic sensitivity for detecting small cell lung cancers ,CYFRA21-1 had the highest diagnostic sensitivity for detecting squamous carcinoma .The combined tests of four serum tumor markers had higher diagnostic sensitivity and accuracy than single test for lung cancers .Conclusion The four serum tumor markers are valuable in the pathological classification ,diagnosis and differential diagno-sis of lung cancer .The diagnostic sensitivity and the accuracy are obviously higher in combined tests .

Objective To explore the impact of lung-protective mechanical ventilation (low tidal volume and optimal positive end-expiratory pressure (PEEP) on cerebral perfusion pressure (CPP) and cerebral oxygen metabolism.Methods Forty patients with severe cerebral injury along with respiratory failure were randomly assigned into two groups:lung-protective ventilation group A and conventional ventilation group B.Group A was planned to prescribe tidal volume 6 ～ 8 mL/kg,initial FiO240％,PEEP gradually increasing from 2 cmH2O to matched with FiO2 elevation,but the FiO2 was kept at permissive lower level.Group B was formulated with tidal volume 8 ～ 12 mL/kg,PEEP stepwise increasing from 0 2 cmH2O to match with FiO2 elevation,but PEEP was kept at permissive lower pressure.The intracranial pressure (ICP),mean arterial pressure (MAP),CPP,arterial and jugular venous blood gas were monitored.Results PEEP (8.2±3.32 cmH2O),ICP (19.7 ±3.6 mmHg),PaCO2 (54±7.3 mmHg),jugular venous carbon dioxide partial pressure (PjV CO2,56.7 ± 9.6 mmHg) in group A were higher than those (5.7±2.3 cmH2O,16.9±3.8 mmHg,41 ±5.2 mmHg,49.8 ±6.9 mmHg) in group B (P＜ 0.05 or P ＜ 0.01).VT,FiO2 in the group A were lower than those in the group B.There were no differences in PaO2/FiO2,jugular venous oxygen saturation (SjVO2),MAP,and CPP between two groups.PaCO2 were significantly correlated with CPP (r =0.368,P =0.019) while there was no correlation with ICP,PaO2,SjVO2,PjVCO2 (all P ＞0.05).CPP (69.7 ± 12.3 mmHg) was higher in case of PaCO2 (46 ～60mmHg) than those (61.5 ±9.1 mmHg) in case of PaCO2 (35 ～45 mmHg).There was correlation between PEEP and ICP (r =0.436,P =0.005).When PEEP was divided into three groups:≤52 cmH2O,6 ～ 102 cmH2O and ＞ 102 cmH2O,ICPs were different one another among three groups.When PEEP ＞ 102 cmH2O,it had a distinguished negative correlation with CPP (r =-0.395,P =0.017),while PEEP ≤ 102 cmH2O,CPP presented decreasing tendency.SjVO2 correlated with PaO2 (r =0.403,P =0.014) and PjVCO2 (r =-0.502,P =0.001) respectively.There were no significant relationships between SjVO2 and CPP,ICP,MAP,PEEP,respectively.Conclusions Lung-protective mechanical ventilation was relatively safer in patients with severe cerebral injury compared with conventional mechanical ventilation.Mild PaCO2 elevation (46 ～ 60 mmHg) combined with higher PEEP (＜ 102 cmH2O) did not decrease CPP.There was no difference in SjVO2 between the two modes of mechanical ventilation,suggesting no changes in cerebral metabolism occurred.

Objective To explore the influence and curative effect of leflunomide combined with ginkgo leaf extract and dipyridamole on hypercoagulable state in patients with nephrotic syndrome.Methods Ninety-five patients who were the first diagnosed nephrotic syndrome were divided into experiment group (50 cases) and control group (45 cases) by random digits table method.The patients in experiment group were treated with leflunomide combined with ginkgo leaf extract and dipyridamole,while the patients in control group were treated with leflunomide.The coagulation function and renal function indexes were respectively detected before and after treatment.Results After treatment,the expression level of platelet activation complexes (PAC)-1 in experiment group decreased from (7.33 ± 1.69)％ to (2.58 ±0.97)％,and the expression level of CD62p decreased from (6.15 ± 1.59)％ to (3.18 ± 1.03)％,which were significantly lower than those after treatment in control group [(7.23 ± 1.41)％ and (5.99 ± 1.51)％],and there were statistical differences (P ＜ 0.05).The prothrombin time in experiment group extended from (10.62 ±0.45) s to (12.88 ± 0.69) s,and the activated partial thromboplastin time extended from (23.33 ± 2.79) s to (30.57 ±3.88) s,which were significantly longer than those after treatment in control group [(11.21 ±0.48) s and (23.46 ± 2.79) s],and there were statistical differences (P ＜ 0.05).The plasma D-dimer in experiment group decreased from (2.58 ± 1.23) mg/L to (0.89 ± 1.12) mg/L,the plasma fibrinogen decreased from (3.68 ± 1.21) g/L to (1.89 ± 0.74) g/L,which were significantly lower than those after treatment in control group [(2.33 ± 1.22) mg/L and (3.25 ± 1.33) g/L],and there were statistical differences (P＜0.05).The serum creatinine,blood urea nitrogen and 24 h urine protein levels after treatment in the 2 groups were significantly lower than those before treatment,but the serum creatinine and 24 h urine protein levels after treatment in experiment group were significantly lower than those in control group [(85.38 ± 18.56) μ mol/L vs.(115.23 ± 20.88) μ mol/L,(1.07 ± 0.38) g vs.(2.57 ± 0.99) g],and there were statistical differences (P ＜0.05).Conclusions The application of the leflunomide combined with ginkgo leaf extract and dipyridamole has great effects on releasing the hypercoagulable state and improving the renal function of patients with nephrotic syndrome.

This paper analyses 150 cases of sclerema neonatorum admitted during the period 1956 to 1980. The results showed that the prognosis of sclerema neonatorum related to the sclerotic degree and infection, and that the mortality was higher in severe cases and cases with infection. The therapeutic effect of combined modality therapy was more significant. Pulmonary haemorrhage was the important cause of death and its clinical manifestations in the early stage were similar to those of acute left heart failure.

Objective To study effect of immediate abundant sucralfate suspension perfusion to prevent upper gastrointestinal hemorrhage on the organophosphorous insecticides toxicosis suffer after washing stomach.Methods Total 83 patients suffering organophosphorous insecticides toxicosis were divided randomly into 2 groups randomly.In the control group,40 samples were given cimetidine 0.4 g by vein injection after stomach washing completely twice one day. Meanwhile,they were taken sucralfate 1.0 g/(4 times day) orally or by nastal feeding,continuing 5 days.In the treatment group,the samples were perfused sucralfate suspension 3.0 g (grind to powder,mixed with warm water 80 ml) by stomach tube after each stomach washing,and given routine treatment to assist (method as the control group).Results In the aspects of recessive hemorrhage,conspicuous hemorrhage and hospitalizing period the treatment group was significant decreased compared with the control group (P＜0.05).However,Analysis of the results showed no significant difference in death rate (P＞0.05).Conclusion Immediate abundant sucralfate suspension perfusion after washing stomach has significant curative effect on preventing upper gastrointestinal hemorrhage and decreasing hospitalizing period.

The proliferation of vascular smooth muscle cells plays an important role in the initiation and aggravation in cardiovascular diseases such as hypertension, arteriosclerosis, restenosis. This article reviewed the progress in the studies on extracellular influencing factors, intracellular signal transduction, cell cycle of vascular smooth muscle cells and the relative drug research and development.

OBJECTIVE:To analyze the general patterns and characteristics of drug-induced lupus (DIL) induced by inflix-imab,and to provide reference for the safety of drug use. METHODS:Usinginfiximab,lupusas searching words,inflix-imab-induced DIL literatures included in CJFD,VIP and PubMed from Jan. 2002 to Jun. 2016 were retrieved and analyzed. RE-SULTS:Totally 30 effective literatures were retrieved,involving 31 DIL patients,there were 8 male cases (25.81%) and 23 fe-male cases(74.19%);17 patients aged more than 50(54.84%). 20 cases occurred within 5-24 weeks(64.51%). 16 patients re-ceived infliximab alone (51.61%). Main clinical manifestations were skin rash or photosensitivie enteritig (15 cases),joint pain (16 cases,multiple arthritis and synovitis)and fever(12 cases). 5 patients suffered from 3 above symptoms simultaneously. Labo-ratory examination mainly manifested as antinuclear antibody,double stranded DNA antibody and anti-histone antibody positive. Thirty patients with DIL received drug withdrawal or steroid hormones treatment,among which the symptoms of 26 patients disap-peared after drug withdrawal or treatment within 6 months,and 1 patient deteriorated. CONCLUSIONS:DIL-induced by inflix-imab invovle patients'age and gender,disease types,family history and other factors. Clinicians should be aware of rules and char-acteristics of DIL induced by infliximab,and tighten drug use monitoring to reduce ADR.

Immune thrombocytopenia (ITP) of childhood is the most common hemorrhagic disease which is characterized by isolated thrombocytopenia.Depending on individual patient characteristics,appropriate initial management for newly diagnosed ITP may be either watchful waiting or pharmacologic intervention.The main options for initial pharmacologic intervention include a single dose of intravenous immune globulin(IVIG) and/or a short course of glucocorticoids.For ITP children with severe or life-threatening bleeding,it is recommended that both platelet transfusions and the combination of pharmacotherapy.Approximately 20 percent of children who present with ITP will progress to chronic ITP(CITP).Children who develop CITP should have an additional evaluation to exclude other disorders.The pharmacologic options for CITP include Rituximab,and thrombopoietin (TPO)/TPO receptor agonist (Romiplostim or Eltrombopag).Combination therapy and novel immunological targeting drugs become more effective treatment options.Splenectomy is only suit for a small number of children with chronic refractory ITP patients who present significant and persistent hemorrhagic symptoms requiring repeated pharmacologic interventions.