Objective To investigate the formation mechanism of string beads sign in peripheral small cell lung cancer (SCLC) and evaluate the significance of it in differential diagnosis among SCLC,peripheral lung adenocarcinoma and peripheral lung squa-mous cell carcinoma.Methods 78 cases of SCLC,69 cases of peripheral lung adenocarcinoma and 33 cases of peripheral lung squa-mous cell carcinoma,confirmed pathologically were included in this study.The positive rates of string beads sign,mediastinal lymph node metastasis and mediastinal lymph nodes larger than primary lung lesions were calculated and analyzed in these three groups.Results 10 out of SCLC cases (12.8%)have string beads sign,in which all mediastinal lymph nodes were larger than lung lesions.Mediasti-nal lymph node metastases were observed in 63(80.8%)of 78 cases,and 42 (53.8%)cases had larger mediastinal lymph nodes than lung lesions.No string beads sign was observed in patients with peripheral solid lung adenocarcinomas,but 25 of 69 cases (36.2%) have mediastinal lymph node metastasis and 2 cases (2.9%)had larger mediastinal lymph nodes than lung lesions.13 cases(39.4%) of 33 patients with peripheral lung squamous cell carcinomas had mediastinal lymph node metastasis,and 6 cases (16.7%)had larger mediastinal lymph nodes than lung lesions.The statistical results showed the positive rate of string beads sign was not significantly different between peripheral SCLC group and peripheral lung squamous cell carcinoma group,but that of mediastinal lymph node and larger mediastinal lymph nodes than lung lesions were statistically different among these three groups.Conclusion To some extent, string beads sign on CT could reflect the biologic character of SCLC.It played an important role in differential diagnosis of peripheral SCLC,peripheral lung adenocarcinoma and periph-eral lung squamous cell carcinoma,but it should be combined with mediastinal lymph node size.

Objective:To analyze the curative effect of ribavirin combined with dioctahedral-smectite(smecta,DS) on ro-tavirus enteritis. Methods:Totally 168 children with rotavirus enteritis, aged from 6 month to 2 years, were randomly divided into 4 groups (3 treatment groups and a control group). All cases were treated with liquid infusion and other supportive treatment. Group A(n = 41) was treated with ribavirin intravenous injection, group B(n = 40) was treated with DS orally, and group C(n = 45) was treated with ribavirin and DS. The effective rate, symptom amelioration time, average hospital stay and side effects were analyzed. Results:Compared with control group,3 treatment groups had higher effective rate and shorter average hospital stay and symptom amelioration time(P

0.05).Thirty-four cases of newly diagnosed children with CR rate was 88.2% (30 cases).Which the expression of PRAME gene,WT1 gene were both positive and negative groups of children with CR rates were 62.5% and 100.0%,there was no significant difference between the 2 groups(P

Objective To determine the content of heavy metals and harmful elements in commercially available Yuanhu Zhitong Capsule. Methods The determination of lead, cadmium, arsenic, mercury, copper and chromium by atomic absorption spectrometry and atomic fluorescence spectrometry was established.Results The recovery rate of the method was between 91.2% and 111.2%, and the precision of the experiment was less than 5%, and the range of each element was good.The stability and reproducibility of the method were good.Lead and cadmium and copper of Yuanhu zhitong capsule in different degree exceeded the standard, while the content of arsenic, mercury and chromium was in accordance with the requirements. Conclusion The method is simple and easy to operate, convenient and quick.The content of the current limit of Yuanhu zhitong capsule still need to establish the quality standard of lead and cadmium, arsenic, mercury, copper and chromium.In this paper, the establishment of the heavy metals and harmful elements determination method of Yuanhu zhitong capsule provide quality control and safety evaluation of reference.

Pathological types of gastric cancer in stage Ⅲ C include T4a-SEN3,T4b-SIN2,T4b-SIN3.Celiac artery metastatic lymphadenopathy fused into blocks,usually from bottom to top.Limited operation space revealed anatomical and pathological factors,the dissection of the celiac artery lymph nodes,processing the left gastric artery root difficulty.Application of novel celiac artery lymph nodes dissection path,avoiding the limitation of the celiac artery lymph node dissection space exposure factors,so that the dissection of the celiac artery lymph nodes is more complete,processing the left gastric artery root easily,reduce the amount of bleeding,shorten operation time,increase the average lymph node dissection and the Ⅲ C gastric cancer resection rate.

AIM To study the therapeutic effect of bone marrow transplantation on mustard gas-poisoned mice. METHODS Mustard-poisoned mice model was constructed by injected mustard gas 20 mg·kg~(-1) subcutaneously. At 4 h, 1 d and 2 d after poisoned by mustard gas, the suspended bone marrow cells (106 cells per time) were injected into mice respectively. After poisoned 3, 5, 7 and 10 d, the numbers of leukocyte and marrow nucleated cells were recorded periodically. At the same time, after poisoned 4 h and 1 d by mustard gas, mice in another group were injected granulocyte colony stimulating factor (G-CSF) 74 μg·kg~(-1) combined with transplantation and changes of the cell number were observed. RESULTS Compared with poisoned group without transplantion, leukocyte number in bone marrow transplanted group presented ascending trend, but there was no statistical significance until the 10 d after poisoned. However, the number of marrow nucleated cell increased significantly from the 5th day. After mice injected bone marrow cells combined with G-CSF, leukocyte increased markedly in earlier stage compared with transplantation only. CONCLUTION The bone marrow transplantation has significant effects on improvement of marrow hematogenic system inhibited by mustard gas.

Objective: To observe the clinical effect of moxibustion on gastralgia of deficiency cold type. Methods: Sixty patients were randomly divided into 2 groups. The 30 patients in the treatment group were treated with Zhao's thunder-fire moxibustion while the other 30 patients in the control group were treated with oral medicine. Results: After one course of treatment, the total effective rate of treatment group was notably higher than that of the control group, showing statistical significance (P<0.05). Conclusion: The total effective rate of thunder-fire moxibustion on gastralgia of deficiency cold type was better than that of the traditional Chinese medicine in relieving epigastralgia.

Objective To investigate the expression of CD44V6 in thyroid neoplasms and its significance. Methods The expression of CD44V6 in paraffin-embeded thyoid carcinoma tissue from 100 patients (50 with lymph node metastasis,50 without) and 20 patients with thyroid adenoma was measured by immunohistochemistry staining. Results Positive expression of CD44V6 in the group of thyoid carcinoma was 72%, significantly higher than the group of thyroid adenoma.Positive expression of CD44V6 in the group of thyoid carcinoma with lymph node involvement was 90%,significantly higher than the group of thyoid carcinoma without lymph node involvement.In patients with different pathological grade,different clinical stage and different survival time, the positive expression of CD44V6 was significantly different. Conclusions The results suggest that CD44V6 can be regarded as an valuable molecular markers to distinguish benign thyroid tumor from malignant tumor, to predict lymph node metastasis and prognosis.

Objective To study the safety and efficacy of continuous intravenous infusion of fentanyl in laser photocoagulation of retinopathy of prematurity (ROP).Methods From March,2014 to January,2015,ROP infants hospitalized for laser photocoagulation in Guangdong Women and Children hospital were randomly (using envelope method)assigned into the fentanyl groupand the control group.In the fentanyl group,the patients were given fentanyl combined with topical anesthesia,while onlytropical anesthesiain the control group.Premature infant pain profile (PIPP)scores,heart rate,mean artery pressure and complications within 3 days after operation were recorded. The concentration of epinephrine, norepinephrine and cortisol in the blood were measured before and after the operation.Student′s t test,non-parameter rank and chi-square test were used to compare the differences between the two groups.Results A total of 82 infants were enrolled in the study,42 in the fentanyl group and 40 in the control group.In the fentanyl group,11 .9% infants had maximum PIPP score ≥6 and 70.0% in the control group,the difference was statistically significant (P <0.05).In the fentanyl group,the PIPP score at the beginning of operation, the maximum PIPP score during operation and the PIPP score at the end of operation were 2.0,3.0and 1 .5, respectively.In the control group,these scoreswere 8.0,8.0and 8.0 respectively.The differences were statistically significant (P <0.05 ).No significant differences existed between the concentration of epinephrine,norepinephrine and cortisol before and after operationin the fentanyl group.However,these concentrations were elevated after the operation than before the operation in the control group (P <0.05).The incidence of complications within three days after operation was 19.0% in the fentanyl group and 40.0% in the control group,and the difference was statistically significant (P <0.05 ).Conclusion Comparing with topical anesthesia,fentanyl combined with topical anesthesia has lower pain scores,less stress responses and fewer complications during ROP laser photocoagulation.Fentanyl combined with topical anesthesia is a safe and effective analgesic method during ROP laser photocoagulation.

Objective To investigate the risk factors for postoperative liver failure of patients with hepatocellular carcinoma (HCC) and bile duct tumor thrombus through a risk evaluation model.Methods The clinical data of 107 patients with HCC and bile duct tumor thrombus who received hepatic resection at the Eastern Hepatobiliary Surgery Hospital from March 2002 to February 2011 were retrospectively analyzed.All patients were divided into the non-liver failure group (98 patients) and liver failure group (9 patients).Risk factors associated with liver failure were analyzed and a risk evaluation model was established.All data were analyzed using the bivariate regression model,and factors with significance were further analyzed using the multivariate regression model.Results Of the 107 patients,105 received hepatic resection + choledochotomy + thrombectomy and 2 received hepatic resection + extrahepatic bile duct resection + cholangiojejunostomy.The operation time was 2.0-5.5 hours,and the intraoperative blood loss was 200-3500 ml.In the non-liver failure group,5 patients had pleural and peritoneal effusion,3 had biliary bleeding,2 had incisional infection,1 had biliary infection,1 had bile leakage,1 had stress-induced ulcer of upper digestive tract and 1 had thoracic epidural hematoma.The bleeding of the patients with thoracic epidural hematoma was stopped after thoracic spinal decompression,but subsequent paraplegia occurred.In the liver failure group,2 patients died of postoperative acute liver failure,and 7 patients died of postoperative subacute liver failure (death caused by tumor recurrence or medicine was excluded).The results of univariate analysis showed that preoperative total bilirubin,albumin,pre-albumin,albumin/globulin ratio,distribution of tumor thrombus,operative blood loss and ratio of postoperative residual liver volume to the total liver volume were correlated with the postoperative liver failure in patients with HCC and bile duct tumor thrombus (OR =3.017,0.191,0.248,2.681,9.048,4.759,13.714,P ＜ 0.05).The results of multivariate analysis showed that preoperative total bilirubin ＞ 256.5 μmol/L,albumin/globulin ratio ≤ 1.3 and postoperative residual liver volume ＜ 50％ were the independent risk factors of postoperative liver failure (OR =5.537,11.107,172.450,P ＜ 0.05).The risk evaluation model was Z =1.77 × preoperative total bilirubin + 2.408 × preoperative albumin/globulin ratio + 5.150 × ratio of postoperative residual liver volume to the total liver volume-17.288.The risk of postoperative liver failure increased as the increase of Z value.The risk of postoperative liver failure ＞ 50％ when the Z value ＞ 0.Conclusions Preoperative total bilirubin ＞ 256.5μmol/L,albumin/globulin ratio ≤ 1.3 and postoperative residual liver volume ＜ 50％ were the independent risk factors of postoperative liver failure.Risk evaluation model is helpful in screening the risk factors so as to decrease the incidence of postoperative liver failure.