Objective To assess the efficacy of interventional bronchoscopic techniques used to treat stenosis of bronchial anastomosis after lung transplantation.Methods A retrospective study of 24 cases who underwent lung transplantation from September 2003 to August 2005 in our Unit was done. All recipients were subjected to surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome were performed for the management of bronchial stenosis or granuloma formation.Results There were 2 of 24 recipients (2/24,8.3 %) with stenosis of bronchial anastomosis. Airway stenosis appeared in 3 of 28 anastomoses (3/28,10.7 %): 2 on the left and 1 on the right. These patients with airway stenosis responded to interventional bronchoscopy,and their respiratory function was improved significantly.Conclusions Despite the improvements in surgical technique and immunosuppression strategies,a small number of patients still had airway complications after lung transplantation. Interventional bronchoscopic techniques,i.e. endobronchial electrocauterization with microwave therapy apparatus and endobronchial electrocoagulation with high-frequency electrotome will be effective in the treatment of airway complications after lung transplantation and with good response in respiratory function.

Objective To investigate the significance of sonographic patterns of thyroid calcification in diagnosis of thyroid nodule.Methods 235 patients with 355 thyroid nodules were retrospectively analyzed.Nodule calcification size,distribution and pattern were observed.Results The incidence of calcification in benign and malignant nodules was 30.3％ (89/294)and 73.7％ (45/61) respectively.The difference had statistical significance(x2 =24.3,P ＜0.01).The rate of microcalcification in cancer was 47.5％ (29/61),higher than that in benign one 3.1％ (9/294)(x2 =99.1,P ＜ 0.01).Coarse calcification in benign nodules and malignant lesion was 27.2％ (80/294)and 26.2％ (16/61)respectively.The difference had no statistical significance(x2 =0.42,P ＞0.05).Conclusions Microcalcification of thyroid nodules is a specific index for thyroid carcinoma.Any type of sonographically detected calcification represents risk of malignancy.Not only microcalcification,these cases should raise the suspicion of malignancy in coarse calcification,especially involving a solitary nodule and irregular shape.

ObjectiveTo compare the performance of color Doppler utrasonography (CDUS) alone,magnetic resonance imagine (MRI) alone, and the combination of the two in the diagnosis of thyroid carcinona (TC). MethodsCDUS and MRI results of 54 focuses of carcinoma in 45 cases diagnosed as TC by postoperative pathological results were reviewed. The sensitivity of CDUS, MRI, and the combination of the two in the diagnosis of TC was compared. ResultsThe sensitivity of CDUS and MRI was 77.78％ (42/54)and 81.48％(44/54) respectively. The difference had no statistical significance (P ＞ 0.05 ). The specificity of CDUS and MRI was 88.17％ and 92.47％ respectively, the positive predictive value was 79.25％ and 86.27％ respectively,and the negative predictive value was 87.23％ and 89.58％ respectively. The sensitivity of the combination of CDUS and MRI was 94.44％ (51/54). The difference between the combination and CDUS or MRI alone had statistical significance( P ＜0.05). ConclusionsCDUS has higher detection rate than MRI in microcalcification of TC focus. However, MRI can show more clearly of the peripheral invasion and cervical lymph node metastasis.The combination of the two can improve the accuracy of TC diagnosis.

Objective This study investigates the protective effect of bicyclol on liver function in patients after liver resection.Methods One hundred and twenty patients undergoing liver resection with Pringle's maneuver were randomly divided into groups A,B,and C,and given bicyclol (50 mg),diammonium glycyrrhizinate (150 mg),and silybum marianum (77 mg),respectively.The medication was orally given preoperatively for 5 days and postoperatively for days 3 to 7.The fasting serum ALT,AST,TB,ALP,and PAB levels were determined before operation and on days 1,3,5,and 7 after operation.Results ALT levels in the A group were significantly lower than those in the B and C group on post operative days 1,3,5,and 7 (P＜0.01).On postoperative day 7,the ratio of serum ALT returned to normal was significantly higher than the B and C group ratios (P＜0.05).Conclusion Therefore,oral bicyclol given before and after liver resection can significantly inhibit the rapid increase and promote the normalization of serum ALT levels.

Objective To evaluate the perioperative period safety of improved transurethral plasma kinetic enucleation of prostate (TUPKEP) in high-risk benign prostatic hyperplasia (BPH) patients with coronary heart disease (CHD).Methods One hundred and twenty-eight BPH patients were selected,24 patients had CHD (with CHD group),among whom 10 patients were given transurethral vapor-resection of prostate (TUVP),and 14 patients were given improved TUPKEP; 104 patients didn't have CHD,among whom 22 patients were given TUVP,and 82 patients were given improved TUPKEP.The serum endothelin (ET)-1 was measured by specific radioimmunoassay at preoperative 2 h and postoperative 1,2,6 d,and complication was observed.Results All the patients were cured by operation,and left hospital smoothly.There were no statistical differences in the preoperative 2 h serum ET-1 in with CHD group and without CHD group (including all TUVP patients and improved TUPKEP patients) (P ＞ 0.05).The postoperative 1 and 2 d serum ET-1 levels of TUVP patients were significantly higher than those of improved TUPKEP patients,in with CHD group:(114.09 ± 15.33) ng/L vs.(94.77 ± 12.14) ng/L and (99.67 ± 9.87) ng/L vs.(88.21 ± 9.55) ng/L; in without CHD group:(70.21 ± 12.44) ng/L vs.(53.67 ± 9.02) ng/L and (61.18 ± 9.52) ng/L vs.(48.54 ± 9.15) ng/L,and there were statistical differences (P ＜ 0.05).There were no statistical differences in postoperative 6 d serum ET-1 in TUVP patients and improved TURKEP patients (P ＞ 0.05).In with CHD group,5 patients had ischemic ST-T change in the early postoperative period,and 3 patients had angina pectoris.They all were promptly treated,and the events were controlled.Serious complications did not present such as acute myocardial infarction (AMI),acute heart failure and sudden cardiac death,etc.Conclusions The postoperative BPH patients have vascular endothelial injury catholically,especially the high-risk patients with CHD.Furthermore,it might be one of the causes of the postoperative adverse cardiovascular events.Compared with TUVP,improved TUPKEP has a minor impact on vascular endothelial function,and it can reduce the postoperative adverse cardiovascular events in the BPH patients with CHD.Improved TUPKEP is a relatively safer surgical method for high-risk BPH with CHD.

Objective To explore the clinical efficacy of laparoscopic gastric ulcer perforation repair com-bined with Helicobacter pylori(Hp)cure.Methods Laparoscopic repair was used in the treatment of gastric ulcer perforation in 45 cases,and 42 cases of postoperative infection were combined Hp eradication therapy.Results The average operative time was 52.5min (36 -83min),mean blood 17.2mL(8 -45mL)in the 45 patients,with no sig-nificant intraoperative complications.The mean 4.5d (3 -8d)normally discharged after an average follow -up of 25 months (18 to 36 months)without significant complications and recurrent perforation.In 42 cases infected with Hp,cure rate of 97.6%,inefficiency of 3.4%,2 -year recurrence rate of 4.9%.Conclusion Laparoscopic gastric ulcer perforation is a minimally invasive,safe and effective surgical method.The surgery is simple,minimal trauma, less pain,faster recovery and fewer complications,Hp infected radical surgery combined with Hp eradication has good efficacy,less recurrence and important clinical significance and value.

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction can restore the stability of knee joint, reduce the mechanical stress on meniscus and cartilage, and avoid the occurrence and development of secondary injury including traumatic arthritis. However, some studies have shown that ACL reconstruction cannot completely prevent the occurrence and development of osteoarthritis, and significant changes in osteoarthritis can be found in the long-term imaging examination after operation. Therefore, there is still controversy about the role of ACL reconstruction in preventing secondary cartilage damage and secondary osteoarthritis, and the changes in cartilage after ACL reconstruction, especially at early stage after ACL reconstruction, have not been fully elucidated. OBJECTIVE: To analyze articular cartilage changes during arthroscopic anterior cruciate ligament reconstruction and second-look arthroscopic evaluation. METHODS: From July 2015 to July 2016, 50 cases of ACL reconstruction with hamstring tendon and second-look arthroscopic exploration were analyzed retrospectively. The cartilage damage and healing between the ACL reconstruction and second-look exploration were recorded. At the same time, the influence of age on articular cartilage was analyzed. The study protocol was approved by the Ethics Committee of Foshan TCM Hospital with an approval No. 20160315. RESULTS AND CONCLUSION: No infection, graft absorption and other complications occurred in all patients. During the second-look exploration, the Lysholm score, International Knee Documentation Committee evaluation score, Tegner score and KT-1000 lateral difference were significantly improved compared with those before operation (P < 0.05). During the second-look exploration, the articular cartilage of all patients had a trend of deterioration; except for the medial tibial platform and the lateral femoral condyle, subpatellar, trochlear, medial femoral condyle and tibial lateral platform articular cartilage tissues were significantly worsened compared with those after the initial ACL reconstruction (P < 0.05). There was no significant difference in the condition of articular cartilage between the patients under 30 years and over 30 years old in the initial ACL reconstruction (P > 0.05). During the second-look exploration, the patients with anterior cruciate ligament reconstruction who were 30 years old and above had significantly worse subpatellar, trochlear, medial femoral condyle, lateral femoral condyle and tibial lateral platform cartilage tissues than those under 30 years (P < 0.05). The results suggest that the reconstruction of ACL with autogenous hamstring tendon can achieve better stability and function of the knee joint. However, even in the early postoperative period, osteoarthritis is still progressing. Therefore, it is necessary for patients with ACL reconstruction to pay attention to the progression of osteoarthritis and the appearance of knee joint symptoms.

Objective:To investigate the correlation between eosinophil count and short-term outcomes of patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke treated in Fuyang People's Hospital from June 2017 to June 2019 were enrolled retrospectively. The demographic and baseline clinical data were collected. The modified Rankin Scale was used to evaluate the short-term clinical outcome at the time of discharge or 14 d after onset. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of poor short-term outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of eosinophil count for poor short-term outcome. Results:A total of 300 patients with acute ischemic stroke were enrolled, including 187 males (62.3%) and 113 females (37.7%); their age was 63.62±12.14 years; baseline National Institutes of Health Stroke Scale (NIHSS) score was 5.48±4.85. Two hundred and twenty-eight patients (76.0%) had a good outcome and 72 (24.0%) had a poor outcome. Univariate analysis showed that age, hypertension, baseline NIHSS score, C-reactive protein, atrial fibrillation, and neutrophil count of the poor outcome group were significantly higher than those of the good outcome group, while male, smoking, eosinophil count and percentage of eosinophils were significantly lower than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that baseline NIHSS score (odds ratio [ OR] 1.726, 95% confidence interval [ CI] 1.400-2.128; P<0.001), hypertension ( OR 3.744, 95% CI 1.227-11.426; P=0.020) and eosinophil count ( OR 0.287, 95% CI 0.102-0.616; P=0.043) were the independent influencing factors for the poor short-term outcome. ROC curve analysis showed that the area under the curve of eosinophil count for predicting the poor short-term outcome was 0.717 (95% CI 0.642-0.792), the best cutoff value was 0.075×10 9/L, and its sensitivity and specificity for predicting the poor short-term outcome were 88.6% and 51.4% respectively. Conclusion:The decreased eosinophil count had a certain predictive value for the poor short-term clinical outcome of patients with acute ischemic stroke.

The aim of this paper is to compare the cytotoxicity and cellular uptake efficiency of three kinds of poly(b-benzyl-L-amino) block-poly(ethylene glycol) nanoparticles (PXA-PEG-NPs) using Calu-3 cells, and select one as a nasal drug delivery vector for curcumin (Cur). Poly(gamma-benzyl-L-glutamate) block-poly(ethylene glycol) nanoparticles (PBLG-PEG-NPs), poly(gamma-benzyl-L-lysine) block-poly(ethyleneglycol) nanoparticles (PZLL-PEG-NPs) and poly(gamma-benzyl-L-aspartate) block-poly(ethylene glycol) nanoparticles (PBLA-PEG-NPs) were prepared by emulsion-solvent evaporation method. MTT assays were used to evaluate the cytotoxicity of PXA-PEG-NPs against Calu-3 cells. The cellular uptake of nanoparticles was visualized by an inverted fluorescence microscope and quantified by a flow cytometer. The results indicated that even at high concentration of 2 mg x mL(-1) the three nanoparticles had no cytotoxicity on Calu-3 cells. Compared to the curcumin solution, the three curcumin-loaded PXA-PEG-NPs showed significantly higher cellular uptake efficiency on Calu-3 cells (at equal concentration of curcumin with 5 microg x mL(-1) Cur solution), PBLG-PEG-NPs group was the highest. The cellular uptake increased with incubation time, and has positive correlation with nanoparticle concentration. In brief, PXA-PEG-NPs are conducive to delivery Cur into cells, and PBLG-PEG-NPs might be provided as a good nasal drug delivery carrier.