Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P ＞ 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P ＜ 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P ＜ 0.05 ). In experimental group anti- X a activity increased postoperative each time (P ＜ 0.05 ),compared with control group was also significant (P ＜ 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.

Objective To investigate the resistance of Staphylococcus aureus (S.aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical anti-infection treatment.Methods S.aureus and methicillin-resistant S.aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration(MIC) values of vancomycin and linezolid against S.aureus and MRSA in each year were calculated.Results A total of 51 976 strains of S.aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02％ in 2011 to 25.56％ in 2015, which showed a downward trend (x2=160.72,P<0.05).From 2011 to 2015, MIC50 of vancomycin against S.aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively,MIC90 increased from 1μg/mL to 2μg/mL;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Conclusion The isolates rate of MRSA had a decreasing trend,but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.

Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.

Chemotherapy is one of the most important methods of cancer treatment.However,multidrug resistance (MDR) has been the main factors affecting their efficacies.Recent studies show that the amplification of MDR1 gene in tumor cells,the over expression of the related drug resistance protein and the cell cycle and apoptosis pathway in signal transduction are the main causes for the failure of chemotherapy.

Objective To investigate the expression of hypoxia inducible factor-1?(HIF-1?) and heparanase(HPA),and their relationship during hypoxia in human ovarian cancer cell line SKOV3.Methods SKOV3 cells were incubated in different groups,immucytochemistry was applied to qualitatively assay HPA protein,Western-blot was used to detect the protein expression of HIF-1? and HPA,and mRNA expression was determined by RT-PCR.Results The positive expression of HPA localized in cytoplasma.Western-blot analysis revealed that the protein expression of HIF-1? was significantly increased(P

[ABSTRACT]AIM:Toinvestigatetheapplicabilityanddegradabilityoftheantigen-extractedxenogeneicbone carrying recombinant human bone morphogenetic protein 2 ( rhBMP-2) as a scaffold in repairing the mandibular defect in vivo.METHODS:New Zealand rabbits (n=28) with 28 mandibular defects were divided into 3 groups at random:anti-gen-extracted xenogeneic cancellous bone /rhBMP-2 group (group A), antigen-extracted xenogeneic cancellous bone group ( group B ) and blank control group ( group C ) .Twelve bone defects each in group A and group B were classified into 3 time points (4, 8 and 12 weeks).Observation in general, X-ray test and hematoxylin and eosin staining and bone density measurement were conducted on each rabbit in group A and group B .Four bone defects were classified into group C .Ob-servation in general , X-ray test and hematoxylin and eosin staining were also conducted on each rabbit in group C .RE-SULTS:The X-ray showed that the implanted materials were degraded after a period of time , and were replaced by autoge-nous bone.At the 12th week, the implanted materials in group A were entirely degraded and replaced by autogenous bone . The bone density measurement showed that the bone density was enhanced after implantation .At the 12th week, there was an obvious difference between group A and group B .The hematoxylin and eosin staining showed there were more neovascu-larization, new fibrosis and new bone formation in group A than those in group B .The implanted material in group A de-graded much faster than that in group B .The significant difference in the new bone area ratio between the 2 groups among all weeks was observed .CONCLUSION: An antigen-extracted xenogeneic cancellous bone has good biocompatibility , which can act as a scaffold in bone repairment .It is the carrier of rhBMP-2 to continue the bone formation .Therefore, anti-gen-extracted xenogeneic cancellous bone is a kind of good material for bone repairment .

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
Anastomosis, Surgical ; Bronchi/*surgery ; Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pneumonectomy/*methods ; Pulmonary Surgical Procedures/*methods ; Recovery of Function ; Treatment Outcome

Presented in this study were three cases of lung cancer undergoing pulmonary venoplasty. In the 3 patients with central type of carcinoma of lung involving pulmonary vein, the main branch of right superior pulmonary vein and the distal end of the superior-lobe vein were occluded. The root part of the vein of right-middle lobe, plus part of vessel of of right superior vein was resected. The right superior vein was reconstructed by continuous 6-0 Prolene sutures. After the operation, the reconstructed was patent and the surgical margin was tumor-free. Postoperatively, clinical manifestations and plain chest films did not show any signs of venous blockade. The patients were discharged healed 3 weeks after the operation. The technical details of the surgery were presented, the improvements on the basis of traditional methods were discussed and its clinical application was evaluated. It is concluded that pulmonary venoplasty is a safe and feasible operation. Further improvement of the surgery will help conserve more lung tissue and benefit more patients because of expanded indications.
Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pulmonary Veins/*surgery ; Vascular Surgical Procedures/*methods

Background In recent years,some researches show that getting younger over the diabetes mellitus (DM) was an obrious trend.But studies of early diabetic retinopathy in young people with diabetes were few.Both patients and doctors did not put enough importance on it.Objective This study was to evaluate the earlier dynamic changes of retina morphology and function caused by type 2 DM in young population.Methods A cohort study was designed.One hundred and thirty-six young patients who were initially diagnosed as type 2 DM in Cangzhou Central Hospital were included from January to March in 2010 and 91 healthy individuals with the matched age were enrolled at the same period.Glycated hemoglobin (HbAlc) level in blood was assayed yearly,and ophthalmoscope,optical coherence tomography (OCT) and visual contrast sensitivity (CS) examinations were performed to evaluate the dynamic changes of retinal nerve fiber layer (RNFL) thickness around optical disc,retinal function and retinal microvessels of DM patients.In addition,the correlation between RNFL thickness or CS and average HbAlc level in DM patients was assessed.This study followed Declaration of Helsinki,and written informed consent was obtained from each subject.Results The levels of HbAlc in DM patients were (7.5 ±1.6) ％,(7.2 ±1.6) ％,(7.4 ±1.6) ％,(7.6±1.6)％ and (7.7 ±1.6)％ in 2010,2011,2012,2013 and 2014,respectively,and HbAlc≥7.0％ was observed in 74 patients (54.4％).The RNFL thicknesses of full optic disk and superior 1/4 quadrant of the optic disk were significantly declined in 2012,2013 and 2014 in the DM group compared with the normal control group (full disk:t =2.216,5.003,7.303;all at P ＜ 0.05.superior 1/4 quadrant:t =2.382,5.657,7.194;all at P ＜ 0.05),but no significant differences were found between them in 2010 and 2011 (all at P＞0.05).In the DM group,RNFL thicknesses of full optic disk were (99.94±10.01) μm and (96.32±10.32) μm in 2013 and 2014,which were significantly lower than (104.55±9.23) μm in 2010 (t=7.819,13.959,both at P＜0.05);the RNFL thicknesses of superior 1/4 quadrant around disk were (118.64± 13.98) μm and (115.06 ± 14.35) μm in 2013 and 2014,which were significantly lower than (127.48± 13.67) μm in 2010 (t =10.504,14.758,both at P＜0.05),However,the RNFL thicknesses were not significantly changed among the different time points in the normal control group (all at P＞0.05).In addition,the CS values of 3.0,6.0,12.0,18.0 c/d in 2013 and 2014 in the DM group were lower than those in the normal control group (all at P＜0.05),and the CS values in 2013 and 2014 were reduced in comparison with 2010 in the DM group (all at P＜0.05).Positive correlations were found between the differences of RNFL thickness or CS and the average HbAlc level in the DM group (r =0.640,F =8.991,P =0.000;r =0.541,F =7.572,P =0.000).Retinal microaneurysms were seen in two type 2 DM patients by ophthalmoscope at the end of follow-up.Conclusions The young people with type 2 DM have poor blood glucose control.The RNFLs are thinning and visual functions are declining in young type 2 DM patients with the lapse of disease course,and these retinal damages are associated with poor control of blood glucose.