Varicella is an acute,highly contagious respiratory and caused by Varicella-zoster virus(VZV),After the primary infection,VZV induce Varicella,then the virus remains dormant in sensory nerve roots in life.Upon the reactivation,shingles can occur.Most of patients can recovery very soon,but kinds of potentially sever complication can induce death.Nowadays the VZV vaccination isn’t included in the expanded immunization program in our country. Varicella outbreaks take place at times in the middle of children of our country.The paper offers concise description about pathogen characteristics,diagnosis methods,clinical character,epidemiology knowledge and strategy of prevention.

Objective To explore the expression of naturally occurring plasma anti-? amyloid (A?) antibody in children and youngsters .Methods According to each 10 years, 28 healthy cases aged from 1~30 years old were diviedd to 3 groups.In the 3 groups,the plasma anti-A? antibody was detacted by immunostained with paraffin sections from Tg2576 mice brain to make a specific tissue amyloid plaque immunoreactivity (TAPIR) and immunoprecipitation analysis. Results The total occurrence rate of anti-A? antibody was 27.8%. There was no significant difference of TAPIR positive rate in each age group. They had the similar immunospecialties to middle-aged and elderly healthy controls. Conclusion Plasma anti-A? antibody can be occured before amyloid deposits and senile plaques in brain.

Objective To compare the application value and the clinical curative effect of longitudinal incision and tarsal sinus minimal-ly invasive approach in treatment of patients with intra-articular calcaneal fractures. Methods A retrospective statistical analysis was made by collecting and comparing the clinical data of 67 patients with intra-articular calcaneal fractures from March 2008 to March 2012,and they were divided into the longitudinal incision minimally invasive approach group ( ZW group,36 patients,37 feet) and the tarsal sinus minimally invasive approach group ( FW group,31 patients,33 feet) . The Bohler angle, Gissane angle before and after operation,complications healing time,and AOFAS scores were compared. Results The healing time,Bohler angle,Gissane angle of ZW group and other indicators were better than those of the FW group,but there was no significant difference between the two groups (P>0. 05). The infection of incision and compli-cations in ZW group was obviously less than those of the FW group (P<0. 05). According to the AOFAS scoring system,ZW group scored 82. 49 points while FW group scored 86. 53 points,which indicated no statistical significance (P>0. 05). Conclusion The two kinds of treatments are of no obvious difference,but the longitudinal small incision minimally invasive approach could receive better effect in terms of soft tissue damage,healing time,and postoperative complications.

Objective To explore the value of left parasternal anterior mediastinaotomy (Chamberlain procedure) in the diagnosis of mediastinal lymph node enlargement with unknown causes and anterior mediastinal space-taking lesions. Methods By using the Chamberlain procedure, biopsy was performed in 32 cases of enlarged mediastinal lymph nodes with unknown causes or mediastinal space-taking lesions, which were found by CT scans. Results All of the 32 cases were pathologically diagnosed, with a diagnostic accuracy of 100%. Three patients with pericardial effusion received concurrent pericardial fenestration and then their symptoms relieved. Four patients underwent concurrent lung biopsy. The operating time was (48?15) min, the blood lose was ( 40.6?23.5) ml, and the postoperative hospital stay (3.6?1.4) days. No deaths or postoperative complications occurred. Conclusions Chamberlain procedure is a safe and valuable method in the diagnosis of mediastinal space-taking lesions with unknown causes or enlargement of the fifth and sixth groups of mediastinal lymph nodes, which routine mediastinoscope cannot reach. Some other simple therapies, such as lung biopsy or pericardial fenestration, can also be employed at the same time.

Objective To compare the clinical efficacy and safety of Qingyi Decoction (a preparation of Chinese herbal medicine) between two different routes of the administration by using nasogastric tube or nasojejunal tube for treatmnent of severe acute pancreatitis (SAP).Methods A total of 79 SAP patients enrolled were randomly divided into nasogastric tube group (n =41) and nasojejunal tube group (n =38) according to the random number table method.In addition to the conventional therapy,they were treated with Qingyi Decoction administered by using nasogastric tube or nasojejunal tube.Results After treatment for 14 days,the levels of C-reactive protein (CRP),procalcitonin (PCT) and white blood cell count (WBC),urinary bladder pressure,and APACHE Ⅱ score in nasojejunal tube group were significantly lower than those in nasogastric tube group (P ＜ 0.05).The time required for the recovery of bowel sounds,length of abnormal serum amylase persistence,the duration of abdominal pain,the time necessary for mechanical respiratory support in nasojejunal tube group was significantly shorter than those in nasogastric tube group.The blood fungus infection rate and pulmonary fungus infection rate in nasojejunal tube group were significantly lower than those in nasogastric tube group,and 28-day survival rate in nasojejunal tube group was significantly higher than that in nasogastric tube group (P ＜ 0.05).Conclusion The nasojejunal tube route for the administration of Qingyi Decoction for the treatment of SAP can effectively alleviate the severity of patient's condition,shorten the time required for improving clinical symptoms,reduce the incidence of morbidity and mortality,and it is worthy of further popularization in clinical practice.

Purpose　To investigate whether thoracotomy can induce lung injury in the operative side and the protection by ambroxol in this procedure.　Methods　24 patients with esophageal carcinoma who were performed esophagectomy with anastomosis over the arcus aortae were randomized into 2 groups:an ambroxol group (ambroxol 1 g iv gtt qd×3,preoperatively) and a controlled group without any respiratory medication.General anesthesia by tracheo-cannula combined with continuous epidual anesthesia were used in all the patients.Bilateral broncho-alveolar lavage(BAL) was carried out after intubation preoperatively and before removal of the cannula postoperatively.Total Phospholipid(TPL),Saturated Phosphaytidylcholine(SatPC) and Total protein(TP) in the BALF were measured.The ratio of SatPC/TPL and SatPC/TP represented the activity of PS.　Results　In the controlled group,SatPC/TPL and SatPC/TP of the left lung(operation side) showed significant difference(P<0.05),compared with the right side(non-operation side).In the ambroxol group,no significant difference of such ratio was showed.　Conclusions　Thoracotomy can induce lung injury and bring out the decrease of PS and increase of protein exudation in the operative side.Large dose of ambroxol can promote in synthesize and secretion of PS and protect those changes.

Objective To analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.

ObjectiveTo study the effects of rehabilitation training on the expression of brain derived neurotrophic factor(BDNF) around the cerebral infarcted area of rats.Methods60 SD rats were randomly divided into rehabilitation group and immobilization group 24 hours after cerebral infarction.The rehabilitation group were given water maze training,rotating bar and rolling cage exercises everyday while the immobilization group were fixed in cages. Histochemistry was used to detect the BDNF expression around the cerebral infarcted area at the 1st,3rd,7th,10th and 14th day after infarction respectively.ResultsAt 1st day after the infarction, the expression of BDNF increased obviously around the infarcted area in both group. More BDNF positive neurons were found in the rehabilitation group than that in the immobilization group at 3rd day (P<0.01). BDNF positive astrocytes showed obvious increasing in both group. BDNF positive neurons decreased with time going, and the color became lighter at the same time .At the 7th day after infarction, there were only a few positive neurons, and seldom obvious positive neurons could be seen around the infarcted area at 10th and 14th day. Great deal of BDNF positive astrocytes were found at 3rd,7th,10th and 14th day, and the rehabilitation group showed more expression than that of the immobilization group(P<0.01).ConclusionsThe rehabilitation training may increase the expression of BDNF which might take an active part in the recovery of the central nervous system injury and the rebuilding of its function.

Objective To investigate the clinicopathologic features of intestinal polypoid lymphoma (PL) in children. Methods The clinicopathologic data of 15 cases of pediatric intestinal PL in Jiangxi Provincial Children 's Hospital were retrospectively analyzed. Immuohistochemistry was used to detect the expressions of CD10, bcl-6, bcl-2, MUMl and ERCC1, then EB virus (EBV)-encoded RNA (EBER) status was tested by using in situ hybridization. Results Amongst 15 cases studied, 13 cases were Burkitt lymphoma (BL), 1 case was diffuse large B-cell lymphoma (DLBCL) and 1 case was between DLBCL and BL (DLBCL/BL). The positive rate of CD10, bcl-6, bcl-2, MUMl, ERCC1 and EBER were 100.0%(13/13), 92.3%(12/13), 0, 7.7 % (1/13), 15.4 % (2/13), 53.8 % (7/13), respectively in 13 BL cases. The clinical stage of 13 patients with BL: 11 cases (84.6 %) Ⅱ stage, 1 case (7.7 %) Ⅲ stage, 1 case (7.7 %) Ⅳstage. The clinical stage of DLBCL and BL/DLBCL: Ⅱstage. 14 cases of PL had survival time without tumors, 24-120 months follow-up, and 1 BL patient inⅣstage without chemotherapy died after 2 months. Conclusion BL is a major subtype of intestinal PL in children, which shows a low clinical stage and a good prognosis.

Objective To explore the method of pre expanded deltopectoral flap for repairing post burn faciocervical scars.Methods Anterior axillary incisions were made and appropriate expanders were implanted above anterior chest wall at the first stage.After a 4 6 months' expanding,the flaps based on perforating branches of the internal mammary artery,branches from the thoracoacromi al area,or perforating branches from deltoid muscle,were designed and raised according to scars and dominant vessels.The donor sites were closed at same time without skin graft.Results 43 patients with 51 flaps were operated for reconstruction of post burn faciocervical scars.All flaps and donor sites survived well.Conclusions Pre expanded deltopectoral flap is an ideal donor site for repairing post-burn faciocervical scars.