Objective:To evaluate the preoperative and postoperative management in lung volume reduction surgery for patients with chronic obstructive pulmonary disease.Methods:All 7 patients were male.Age ranged from 65～76 years.Preoperative dyspnea index was grade 4 in 4 and grade 3 in 3.FEV1 were all less than 50%.We performed unilateral Lung volume reduction surgery on the lung that was estimated to have poorer lung function.The resected lung volume was 20%～30% of the operated.Results:2 tracheotomy were performed.Postoperative oxygen supply lasted 6～8d.The symptoms such as palpitaion,dyspnea were improved significantly.FEV1 and dyspnea index were respectively increased by 30%～45% and 1～2 grade.All patients recovered.Conclusions:Preoperative adjustment of the balance of water and electrolyte,proper respiratory exercises,resasonable postoperative oxygn supply and maintenance of unobstructed respiratory tract,all these are important.Moreover,tracheotomy shoulde be perfored promptly in acute cases.

Objective:To prepare enteric-coated pellets of ( R)-rabeprazole sodium and investigate the drug release behavior in vitro. Methods:The pellets of ( R)-rabeprazole sodium were prepared by a fluid bed coating technology, and HPMC and Eudragit L30D-55 was used as the material of isolation layer and enteric coating, respectively. The similarity of in vitro drug release was com-pared between the reference preparation and the self-prepared preparation. Similar factor ( f2 ) was used to evaluate the similarity of re-lease curves. Results:The coating formula of ( R)-rabeprazole sodium enteric-coated pellets was as follows: the weight of HPMC E5 and Eudragit L30D-55 was 12. 0% and 45. 0%, respectively, and the plasticizer was 8. 0% of the weight of the polymers. The f2 of the reference preparation and the self-prepared preparation was more than 50, which indicated the release behavior was similar. Con-clusion:The release behavior of ( R)-rabeprazole sodium enteric-coated pellets is quite promising, and the preparation technology can be used in the industrial production.

Urinary tract infection complicated with urinary tract calculi( lithangiuria)is one of the most common diseases causing serious urinary sepsis and septic shock. Recent studies show that the accurate diagnosis,rational use of antibiotics and timely treatment of complications are the key to treatment success. In this article,the latest progress and the treatment strategies for urinary tract infections complicated with lithangiuria are explored.

Objective To investigate the procedures and therapeutic effects of reoperation of papillary thyroid carcinoma with lymph node metastasis.Methods The clinical data of 10 papillary thyroid carcinoma patients with lymph node metastasis received reoperation were retrospectively studied. Results Reoperation was successfully performed in 9 patients except one patient with tumor surrounding common carotid artery and brachial plexus who had partial tumor removed. Three patients had simple lymphectomy,2 had complete thyroidectomy, 2 had complete lobectomy plus ipsilateral cervical lymph node dissection and 2 had tumor resection plus cervical lymph node dissection. There were no new complications. Conclusions Papillary thyroid carcinoma has the characteristic tend to spread to spread to cervical lymph nodes. Rreoperation offers good outcome for recurrent papillary thyroid carcinoma.

Objective To investigate the effects of rapamycin which is an autophagy inducer and 3-adenine (3-MA) which is an autophagy inhibitor on motor behavior and autophagy related protein LC3 in C57BL/6 mice of Parkinson's disease(PD).Methods 40 C57BL/6 male mice were randomly divided into control group and experimental groups which consist of MPTP model group,rapamycin group and 3-MA group,with 10 in each group.Mice in experimental groups received intraperitoneal injection with MPTP to establish PD models,and mice in control group received intraperitoneal injection with the same amount of saline solution for 1 week.Mice in rapamycin group received intraperitoneal injection with rapamycin and mice in 3-MA group received intraperitoneal injection with 3-MA at the same time when MPTP was injected.Animal behavior detections were carried out on the 1 th,7th and 14th day after the last injection.After the last injection,mice were sacrificed and sections of midbrain nigra were gained for the detection of expression of autophagy specificity protein LC3 by Western Blot.Results Compared with MPTP model group,rapamycin could improve the general condition and behavioral manifestation of mice in pole test((14.89± 1.14) s vs (16.24±1.39) s,P＜0.05;(15.18±1.36) s vs(17.93±1.11s),P＜0.01),traction test((1.7±0.5) vs (1.2±0.4),P＜ 0.05;(1.5±0.5)vs (1.1±0.3),P＜0.05) and open field test which contained total activity distance((5 875.3 ± 1148.9) cm vs (5 061.5±773.1) cm,P＜0.05;(5 753.2± 1 106.7) cm vs (4 669.3±969.1) cm,P＜0.01) and average speed((19.29±2.35) cm/s vs (16.47±3.01) cm/s,P＜0.05;(18.71±2.71)cm/s vs (15.80±2.50) cm/s,P＜0.01),while 3-MA aggravated behavioral deficits of mice in pole test(19.92± 1.61s vs 17.93± 1.11 s,P＜0.05),and both total activity distance((3 879.7±575.0) cm vs (4 669.3±969.1) cm,P＜0.05) and average speed((13.34± 1.87) cm/s vs (15.80±2.50) cm/s,P＜0.05) in open field test were decreased.The results of Western Blot confirmed that rapamycin could increase the expression of LC3-Ⅱ,however 3-MA could re duce the expression of LC3-Ⅱ.Conclusion This study confirmed that rapamycin could alleviate behavioral symptoms of PD model mice and increase the level of LC3 in midbrain nigra,while 3-MA could exacerbate behavioral symptoms in PD model mice and decrease the level of LC3 in midbrain nigra.Thus it can be speculated that drugs which can regulate autophagy may be potential treatment protocols for PD.

Objective To observe the changes of inflammation cytokines in pancreas tissues of experimental acute necrotizing pancreatitis (ANP) rats treated with rhubarb.MethodsThirty-three rats were randomly divided into sham operation group,ANP group and rhubarb treatment group with 11 rats in each group.ANP model was induced by retrograde injection of 3％ sodium taurocholate into the biliopancreatic duct,and jejunostomy was performed.Rats in rhubarb treatment group were fed with 1 g/ml rhubarb at the dose of 1 ml/kg body weight via jejunum route.Thirty-six hours later the rats were sacrificed.The serum level of amylase was measured; part of the pancreatic tissue was harvested for routine pathologic examination; total RNA was extracted from pancreatic tissue.The expression of IL-6,IL-8,and TNF-α mRNA was measured by real-time PCR.ResultsAfter ANP induction,the serum level of amylase was significantly increased,and pancreatic tissue necrosis,bleeding and inflammatory cell infiltration were observed,which was consistent with changes of ANP.The expressions of IL-6,IL-8,and TNF-α mRNA were 0.29 ±0.13,0.35 ±0.15,1.09 ±0.32 in sham operation group,while they were 2.23 ±0.49,2.26 ±0.51,5.24 ±0.59 in ANP group,which were significantly higher than those in sham operation group ( P ＜ 0.05 ).The corresponding values were 0.97 ±0.30,1.02 ±0.34,2.59 ±0.36 in rhubarb treatment group,which were significantly lower than those in ANP group,but they were still significantly higher than those in sham operation group ( P ＜ 0.05 ).ConclusionsRhubarb lavage via jejunum route can decrease the expressions of IL-6,IL-8,and TNF-α,therefore attenuate the pancreatic pathologic injuries.

Objective To observe the clinical effect of edaravone combined with fibrinolysin for treating acute cerebral infarc-tion .Methods 80 cases of acute cerebral infarction were randomly divided into the two groups .The treatment group(40 cases) was treated by edaravone injection 30mg plus normal saline 100 mL by intravenous drip ,twice daily ,fibrinolysin injection 100 U plus 5%glucose injection 250 mL by intravenous drip on 1 d ,subsequently 200U plus 5% glucose 250 mL by intravenous drip from the next day ,for 14 d;the control group(40 cases ) used fibrinolysin alone ,the dose and usage were same to the treatment group .The neuro-logical impairment scale scores(NIHSS) were monitored before and after treatment in the two groups .Results The NIHSS scores and Barthel index on 7 ,14 ,30 ,90 d after treatment in the treatment group were superior to those in the control group (P<0 .05) ,no statistical difference before treatment between the two group existed .Conclusion Edaravone combined with fibrinolysin has better effect for treating acute cerebral infarction .

Objective To explore the clinical effect of auricle reconstruction with expanded auricle posterior flap on mastoidea and auto rib cartilage bracket for repair of congenital microtia.Methods Twenty-one eligible patients with congenital auricle malformation and defect were recruited into this study and three-stage operation was performed.A 50 ml kidney-shaped expander was implanted at mastoid process area to expand skin in stage Ⅰ surgery,followed by a regular affusion to expand skin for 3 to 4 months.The average total waterflood was (80.51 ± 3.87) ml.The volume remained stable for 1 month,once up to the predetermined amount.In stage Ⅱ surgery autogenous costal cartilage was taken and carved into inverted conch shape.Auricle was reconstructed with the expanded flap to cover the auto rib cartilage bracket.The stage Ⅲ surgery was performed for details dressing of the auricle after 3 months.Results All 21 cases underwent operation successfully.Reconstructed ear auricles were similar to uninjured sides in size and shape.Both doctors and patients were contented with the auricles.Conclusions Expanded auricle posterior flap on mastoidea can cover the auto rib cartilage bracket.Autologous costal cartilage can be carved to four layers cartilage bracket that likes an inverted conch,and followed by realistic postoperative auricular shape and strong three-dimensional sense after operation.

Objective To study the clinical efficacy of autologous cartilage following unilateral cleft lip and palate repair on correction of secondary complex deformity.Methods 17 patients with complex secondary cleft palate were enrolled in this study from December 2004 to December 2014.Correction of nasal and lip deformity and oronasal fistula were achieved at the same time.The therapeutic efficacy was evaluated after follow-up from 3 months to 2 years after operation.Results All 17 patients received satisfactory results,of which 14 patients were satisfied and three cases of general satisfaction.Conclusions Satisfactory results are received by using autologous rib cartilage to repair secondary complex deformity of unilateral cleft lip and palate.

Objective To investigate the application of multiple dilators for excessive expansion of scalp with hair covering and integrated use of expanded flap to repair cicatricial alopecia in a large area.Methods stage Ⅰ surgery was performed as follows:multiple dilators were chosed and embedded below the galea aponeurotica of the scalp with hair covering according to the bald hair shape,size of the alopecia area.Excessive expansion was conducted for 3 to 6 months to get the extra hair scalp.Stage Ⅱ surgery was as follows:Dilators were removed and scar areas were resected,followed by combined use of sliding advancement flap,rotation flap and translocation flap to repair scalp alopecia.Resluts The postoperative effect of all patients was ideal with satisfied appearance.Conclusions Multiple dilator excessive expansion may obtain a large number of additional expansion scalp,combined by reasonable use of skin flap transfer technology,which can be used to repair the large scarring alopecia and get a good clinical effect.