Objective To study effectiveness and safety of lung volume reduction surgery(LVRS) in treatment for severe chronic emphysema(chronic obstructive pulmonary disease).Methods Clinical data of 24 patients of severe chronic emphysema undergone with LVRS during January 2004 to June 2007 were analyzed retrospectively.LVRS was performed for the patients after respiratory tract preparation based on their pulmonary function,results of blood gas analysis,cardiac function,as well as physical activity capacity.and surgical incision Was selected based on"target"location of emphysema with chest computerized tomography and isotope lung perfusion scanning,22 cases with standard unilateral LVRS via outer post-lateral incision and two with bilateral LVRS via mid-sternal incison.A linear device for cutting and stitching was used in surgical operation to excise the lung tissues of severe emphysema with strips of bovine pericardium to prevent air leakage.Results All the patients were followed-up for 19 months in average and complications occurred in seven of them after operation,including four with leakage of the alveoli.two with cardiac arrhythmia and one with pneumonia,and no death was observed.Pulmonary function and symptoms of dyspnea improved obviously in all the patients after operation,and they all could care for themselves,in general,with scales of dyspnea increased to grade Ⅰ in one case,to grade Ⅱ in 10 cases and to grade Ⅲ in three cases.Conclusions LVRS can improve pulmonary function of selected patients with severe emphysema,to certain extent,and its safety will depend on strict selection of the patients and correct peri-operative care.

Objective: To observe the clinical outcome of surgical treatment for malignant thymoma,and evaluate the prognostic factors thereof. Mothods:All patients (63 eases)were operated and followed by radiotherapy. The Logistie regression analysis was used for the relationship between the prognosis, Masaoka staging,L/B pathology ,and the differences of the operation given.Rosults:Patients with early Masaoka stage and who received radical resection of thymoma had higher 3 and 5 year survival rates (P＜0.05).The radiotherapy after surgery was related to 3 and 5 year survival rates. The differences of L/B pathology was not related to 3 and 5 year survival rates.Conclusion :The survival rate is enhanced for patients with malignant thymoma when both surgical and radiotherapy intervention axe given as early as possible.The Masaoka staging, not L/B pathology, is closely related to the prognosis.

Objective To explore the value of immunofluorescent technique for clinical diagnosing Duchenne muscular dystrophy(DMD),Becker muscular dystrophy(BMD) and Limb-girdle muscular dystrophy(LGMD).Methods Immunofluorescent technique was applied,and the expressions of Dys1,Dys2,Dys3 monoclonal antibodies and ?-,?-,?-sarcoglycan(SG) polyclonal antibodies against dystrophin,?-SG,?-SG,?-SG in musculomembranes of frozen section specimens from 25 patients(10 cases of DMD,4 cases of BMD and 11 cases of LGMD) were detected.Results 10 DMD patients had negative staining of dystrophin,and 4 BMD patients had discontinuous or a patchy positive staining pattern.All LGMD patients had positive dystrophin staining.There was one patient presented negative staining of ?-SG and ?-SG,respectively.Conclusions Detecting of dystrophin by immunofluorescent technique is special and helpful in diagnosing and classifying DMD/BMD.At present,SG may not be used in diagnosing the LGMD patients.

Objective To evaluate the postoperative complications and visual quality after manual small incision cataract surgery (MSICS) versus phacoemulsification (PHACO).Methods A systematic review of MSICS and PHACO was conducted by a computer search on Medline,Pubmed,CBM and CNKI and a supplementary manual search was also done.The effect was measured as an odds ratio (OR) and weighted mean difference (WMD).RevMan 5.0 software was used to perform the Meta-analysis.Results A total of 9 articles were included in the Meta-analysis.Naked visual acuity at 1 week after surgery (OR =0.93,95％ CI 0.68-1.27),posterior capsular ruptured after surgery (OR =1.07,95％ CI 0.73-1.58),corneal edema after surgery (OR =0.90,95 ％ CI 0.70-1.16),surgically induced astigmatism at 1 month after surgery (WMD =0.08,95％ CI-0.02-0.17) in MSICS and PHACO was no statistically significant difference (P ＞0.05).Conclusion MSICS is safe and reliable surgery as same as PHACO for the patients with cataract,MSICS is more consistent with China' s national conditions.

Objective To explore the level and main functions of P-type ATPase7B in hepatic cells of patients with hepatolenticular degeneration(HLD).Methods The hepatic cells from 5 normal controls and 9 patients with HLD were cultured in vitro. P-type ATPase7B levels in hepatic cells were examined and compared by SDS-PAGE and Western-blot techniques.Results Compared with the controls, 9 patients displayed various changes of electrophoresis strip. Almost normal strips at 155?103 were found in 3 cases, no strip was found in 1 case, and thinner and lighter strips were showed in the remain 5 cases. 6 cases presented abnormal specific reaction strips.Conclusion Mutations of gene ATPase7B in HLD patients cause change of P-type ATPase7B in quantity and quality, thus leads to dysmetabolism of copper.

Objective To study the prevalence and clinical features of auras in epilepsy patients,and to evaluate the diagnosis criteria of epileptic auras.Methods All 1028 patients with epilepsy who were treated in the First Hospital of PekiIIg University from January 2007 to January 2008 were enrolled in this retrospective study.Seizure types were diagnosed in accordance with the seizure classification scheme proposed by the International League Against Epilepsy(1981).We studied the incidence rate,clinical features and presentations of electroencephalogram(EEG)and neuroimaging of epileptic auras.Student ttest was used to assess the statistic difference of the onset age of partial seizure in patients with and without auras.The chi-squaretestWas usedto statistically analyze the EEGand neuroimaging results in patients with partial seizure and the occurrence percentages of abdominal aura in lateral temporal lobe epilepsy(LTLE)and mesial temporal lobe epilepsy(MTLE).Results Four hundred and eighty-four patients(66.8 % of 725 patients)with partial seizures reported epileptic auras.None of the 303 patients with generalized seizures reported auras.Sixty-four patients experienced two or more types of auras.Fourteen patients had aura status. Of all enrolled patients,53.2 % and 21.1 % showed abnormal EEG and neuroimaging,respectively.Of 484 partial epileptic patients with auras,59.1 % and 26.0 % presented abnormal EEG and neuroimagings,respectively.The percentage of abdomen aura in patients with MTLE was significantly higher than those with LTLE(x2=170.877,P<0.01).Condusion Analysis of auras may help in classifying and localizing epilepsy and also in planning treatment.

Objective To review physical examination data of farmers and provide suppoa for the establishment of a proper health management model.Methods More than 3700 farmers living at 11 villages of Xihongmen County in Daxing District of Beijing received healthcare education and essential physical examination from 2007 to 2008.The participants were also required to fill in a health questionnaire in 2008.Results In blood pressure and lipid profile measurement,statistical difference in body mass index was found between the farmers and healthy ubran residents (P<0.05).Conclusion Effective health management models should be explored and established in consideration of the characteristics of the farmers.

Objective To investigate the association between drainage volume and removal of chest tube after video-as?sisted thoracoscopic surgery(VATS) lobectomy. Methods Patients with VATS were randomly divided into three groups:the drainage volume was less than 100 mL/24 h (group A), the drainage volume was more than 100 mL/24 h but less than 200 mL/24 h(group B) and the drainage volume was more than 200 mL/24 h but less than 300 mL/24 h (group C). According to in?clusion criteria and exclusion criteria, finally there were 90 patients in group A, 87 patients in group B and 83 patients in group C. The duration of chest-tube drainage, the occurrence of pulmonary infection, pulmonary atelectasis, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tube, the dosage of analgesic and the length of hospital stay af?ter surgery were recorded. Data were analyzed statistically. Results The average durations of chest-tube drainage were (91.76±15.59)h, (84.17±18.33)h and (56.14±12.25)h, the average morphine consumptions were (236.82±67.20)mg, (187.36± 76.64)mg and (139.29±52.74)mg, and the average lengths of hospital stay after surgery were (11.47±1.90)d, (10.68±2.50)d and (10.23 ± 2.14)d for three groups of patients, respectively. And the indexes in group C were distinctly lower than those in group A and group B (P<0.05). There were no significant differences in pulmonary atelectasis, the occurrence of postopera?tive pulmonary infection, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tubes between three groups of patients (P > 0.05). Conclusion It is safe and acceptable that the removal of chest tube after VATS when the drainage volume reaches 300 mL within 24 h.

The stereoscopic orientation of the lumbar zygapophyseal joints and the stability triangle of the motion segments were studied on 56 sets of adult lumbosacral skeletons. The orientation of the lumbar zygapophyseal joints changed gradually from about sagittal plane in upper segment to about coronal in lower. The gravity center of the stability triangle of the motion segments moved backward from upper to ower progressively. Therefore, the stability of lumbar spine decreases and the mobility increases successively from upper downward.

The architecture of the specialized myocardial fibers of the atrioventricular junction area(AVJ) were observed under microscope on serial sections. It was found that the human A-V node extend backward divergently to form two posterior extensions (left and right, LPE, RPE). The A-V node can be divided into a superficial layer and a deep layer, and the deep layer further divided into a upper part and a lower part. The fibers in the superficial layer are vertical, and join with the lower part of the deep layer at the anterior extremity of the node. The lower part of the deep layer is the main axis of the node. The fibers in the lower part of the deep layer are longitudinal, and join with the RPE at the posterior extremity of the node. The fibers in the upper part of the deep layer are oblique and join with the LPE at the posterior extremity of the node, and mix with the lower part at the anterior extremity. The longitudinal dissociation of the anterior part of the His bundle is more distinct than that of the posterior part. The lower-left part of the bifurcating part of the bundle extend to form the posterior left branch, the upper-left and upper-middle parts of the bifurcating part extend to form the anterior left branch, and the right part and lower-middle part of the bifurcating part extend to form the right bundle branch. The morphological evidence of the dual or multiple conducting pathways, the longitudinal dissociation and the reentry pathways in the AVJ were discussed.