0.05); while in nuclear positive group, the positive rate of p53 was significantly higher than that in nuclear negative one (P

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

Objective To explore the clinical features, diagnosis, and treatment of Kawasaki disease in neonates. Methods The diagnosis and treatment of incomplete Kawasaki disease in one case were retrospectively analyzed. The related literatures were reviewed. Results Male infant had persistent fever with rash at 26 days after birth. The anti-infective treatment was ineffective. No abnormality was found in the first coronary artery ultrasonography. However, coronary artery dilatation was confirmed by ultrasonography after skin peeling at fingertips. After the treatment of gamma globulin and aspirin, the symptoms of fever and rash were improved. The left dilated coronary artery returned to normal after 3 month. The size of coronary artery and the corresponding indexes were normal in 6-months, 1-year and 3 year follow-ups. Conclusion Neonatal Kawasaki disease is rare and atypical.

Objective:To explore the relationship among childhood psychological maltreatment,online aggressivebehavior and trait anger in college students.Methods:Totally 442 college students (226males,216 females,aged 16-25 years) were surveyed with the Psychological Maltreatment Scale (PMS),Adolescent Online Aggressive Behavior Scale (AOABS) and Trait Anger Scale (TAS).The bias-corrected percentile bootstrap method was used to analyze the mediating effect of trait anger between childhood psychological maltreatment and online aggressive behavior.Results:The scores of PMS,AOABS and TAS were positively correlated each other(r =0.44,0.37,0.48,Ps ＜0.01).The PMS scores had a significantly direct effect on the AOABS scores,its estimate was 0.27.The PMS scoreshad a significantly indirect effect on the AOABS scores through TAS scores(95％ CI:0.15-0.34).Conclusion:It suggests that the trait anger may be related to childhood psychological maltreatment and online aggressive behavior,and trait anger may play a partial mediating role between childhood psychological maltreatment and online aggressive behaviorin college students.

Objective:Evaluating the operative methods,complication,feasibiltity and safety of one-stage treatment by thoracoscopy for bilateral pneumothorax or pneumothorax combined with contralateral bullae.Methods:21 patients diagnosed as simultaneous bilateral pneumothorax or ipsilateral recurrent pneumothorax with contralateral bullaes received one-stage treatment by bilateral thoracoscopy.Results:all patients received VATS,postoperative complications include prolonged air leak over 4 days(2 cases), reexpansion pulmonary edema (1 case),and one patient required temporarily mechanical ventilation.There were no postoperative death.All patients recovered smoothly.Follow-up time ranges from 7 to 77 months (mean 32.7 months).Compared with the 127 thoracopcopic procedures of unilateral pneumothorax,there's no statistics difference in complications (χ2=1.7247,P＞0.05). Conclusions:one-stage VATS is a safe and effective procedure for bilateral spontaneous pneumothorax or pneumothorax combined with contralateral bullae.

10.3969/j.issn.1000-3606.2013.06.020

Abstact:Objective To study the relationship between acute mountain sickness and geographic factors in young males,and provide no-vel materials for screening susceptible population and exploring novel research ideas and methods. Methods Total 294 young men came from low altitude were randomly selected,questionnaire was conducted and military AMS standard was applied for diagnosis. Binary logistic re-gression was used to analyze the relationship between 10 different geographical factors and AMS incidence and figure out the risk factors for medical geographical differences of AMS. Results AMS incidence was 52. 04% (153 people),with most commonly seen dizziness,head-ache,shortness of breath,chest tightness and lip empurples,the occurrence was 89. 54%,84. 31%,66. 01%,65. 36% and 60. 78%,respec-tively. Binary logistic regression analysis revealed that altitude was the only geographical risk factor (OR=0. 998,P<0. 05). Conclusion Among the population who entered plateau,lower native altitude they used to live brings higher risk of AMS,therefore corresponding preven-tions should be adapted for those who come to high altitude from low altitude in order to ensure their health and safety.

In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schonlein purpura nephritis (HSPN), 31 children with IgA nephropathy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 %children with IgA nephropathy, but only 10 % in HSPN (P＜0.05). The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia,compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6% of HSPN and 29 % of IgA nephropathy (all P＜0.01). Thin basement membrane nephropathy was only found in 6.5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, loose and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2 %of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits,moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71.9 % of HSPN had IgG deposits in glomeruli and only 19.4 % of IgA nephropathy showed glomerular IgG deposits (P＜0.01). No IgG deposit was observed in 81.6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn't be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5 % of HSPN, but only 19.4 % in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16.1% had active nephritides (P＜0.05). It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn't support the one disease entity hypothesis.HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.

Objective To analyze the clinical and pathological characteristics of Alport syndrome in children. Methods Clinical and pathological information gathered from 62 patients during March 1989 to August 2012 was retrospectively analyzed. Results Four autosomal recessive Alport syndromes (AR-AS) and 58 X-linked Alport syndromes (XL-AS) were analyzed. Of the XL-AS, 47 were boys and 11 were girls. Most of patients induced by upper respiratory tract infections, and onset with hematuria and proteinuria. There was no signiifcant gender difference in family history, impaired renal tubular proteins, hypertension, im-paired renal function, hearing loss, ocular abnormalities or renal pathological changes under light microscopy. However, extensive lamination and split of glomerular basement membrane (GBM) dense layers were found in 83.0%male and 18.2%female patients (P=0.000) and the rest patients were presented with limited distribution of typical GBM changes. Proteinuria progressed signiif-cantly with age in XL-AS males (r=0.501, P=0.000). Five XL-AS patients developed to end stage renal disease (ESRD) between 11 to 16 years old. Conclusions XL-AS is the main inherited type and severe changes of GBM are common in XL-AS males. Proteinuria increases remarkably with age. The detection of type IV collagen in renal tissue or skin is helpful to diagnose Alport syndrome and conifrm inheritance modes.

Objective: To explore the effect of mental health education on the problematic social media use among college students, and to provide the basis for college mental health education in colleges and universities. Methods: Problematic Social Media Use was used to select 44 college students who were randomly assigned into experimental and control group. The experimental group received psychological intervention once a week for eight weeks, and the control group did not receive any intervention. Loneliness Scale,Univesity of California of Los Angels(UCLA), Multidimensional State Boredom Scale(MSBS), Interpersonal Anxiety Scale(IAS) were administered before and after the experiment in both of the groups. Results: There was no significant differences between the experimental and the control group in total score of UCLA, MSBS, IAS and AQPMS. After intervention, prevalence of problematic mobile social media use in experimental group decreased from 100.0% to 45.8%. After intervention, significant differences in total score of UCLA, MSBS, IAS and AQPMS were observed in experimental group(P<0.05), as well as between the experimental group and the control group(P<0.05). Conclusion Mental health education can effectively reduce problematic mobile social media use, as well as negative emotions of college students.