The development of the minimally invasive targeted ablation tendency creates a new therapy for lung cancer. This treatment is featured with considerably extensive indication ,excellent local control and survival time, low incidence and controllable complications. There are many strong proofs of clinical efficacy and safety in this field presently.

Objective To investigate the value of brainstem auditory evoked potential (BAEP) in early diagnosis of severe hand,foot and mouth disease (HFMD) with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years (n =80).Group B included the severe cases who were younger than three years(n =94).Group C included the general cases who were three years or older(n =38).Group D included the severe cases who were three years or older(n =85).The electroencephalogram (EEG) and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results (1) The BAEP abnormal rate of group B (18/94,19.15％)was higher than that of group A (3/80,3.75％),and the BAEP abnormal rate of group D (13/85,15.29％) was higher than that of group C (1/38,2.63％) (P ＜ 0.05).(2) The EEG abnormal rate in group B was low(2/94,2.13％) and there was no case with abnormal EEG in group A.(3) The EEG abnormal rate of group D (49/85,57.65％) was higher than that of group C (6/38,15.79％) (P ＜0.05),and higher than the BAEP abnormal rate of group D.(4) The MRI abnormal rate of group B (9/94,9.57％) was higher than that of group A (1/80,1.25％) (P ＜ 0.05),and the MRI abnormal rate of group D (9/85,10.59％)was higher than that of group C (0).(5) The BAEP abnormal rate of the children with severe HFMD (31/179,17.32％) was higher than the MRI abnormal rate (18/179,10.06％) (P ＜0.05).Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.

Objective Discuss how to develop nurse arrange in groups mode in basic level hospital, resolve more effectively the problem of nurse delayed on duty to ensure nursing care quality and patients' safety.Methods Divide nurses of different level, different working ability and work experience into several groups to carry on arranges in groups.According to the quantity of patient in ward, the nursing work load, nurse establishment and so on, arrange groups with different number of nurse to attend duty.Results Realized nurse level management, the senior nurse's sense of responsibility strengthened, the work value feeling promoted, nurse delayed on duty rate reduced 89.5%;has realized three satisfactions, namely doctor, nurse, the patient were satisfied.Conclusion Basic level hospital, according with practical work characteristics, develop arranges in groups pattern continuously, and thus has safeguarded the noon and at night patient's safety well, has manifested truly take the patient as the center service idea;reduced times of handover, effectively save time of work, raises the working efficiency, reduces the safe hidden danger;realized nurse level management, enhanced nurse the value feeling.

OBJECTIVE To discuss the management experience of protective measures for emergently admitted influenza H1N1 patients in our hospital who were converted from general ward into isolated ward in no more than three hours.METHODS Laying out the guideline of the work,personal training and personal protective measures were taken to manage the staff who working in the isolated ward.RESULTS There was statistically significant difference in hand washing,wearing mask and head wear,taken off gloves,mask and clothes among medical staff who worked in the isolated ward,in comparison with staff from other ward and non-medical staff From 14 points of suruey.there were 8 points were over 80% pass rate.The use of protective equipment was correct.without any cross infection.CONCLUSIONS Management of protective measures plays an important role in control of cross infection in treatment of H1N1 patients.

Objective To investigate the changes of liver function and white blood cell of patients with liver cirrhosis,portal hypertension and secondary hypersplenism underwent laparoscopic splenectomy(LS) and open splenectomy(OS).Methods We analyzed 76 clinical data of patients with liver cirrhosis,portal hypertension and secondary hypersplenism,among those 27 underwent LS,49 OS from Mar 2003 to Mar 2006 retrospectively.Blood samples were obtained and analyzed preoperatively and postoperatively on days 1,3, and 7,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),directed bilirubin(DBil) and white blood cell(WBC).Results Between LS and OS,the serum levels of Tbil and Dbil had significant difference on the 1st postoperative day(P

Hepatitis, Autoimmune ; Humans ; Immunoglobulin G

Objective To investigate the lung function testing performing in normal smokers,and urge smokers to stop smoking early. Methods Two hundred and one adult men did the pulmonary function testing by MINATO AS-505 portable spirometer, and analyzed the effect d different smoking degree on the pulmonary function. Results There was no relationship between lung volume index and smoking, smoking degree. Compared with nonsmokers, the indicants such as FEV1, MVV, FEV1/FVC had decreased, and the indexes of the small airway function (PEF, FEF25%-75%)had significantly dropped in the smokers. And the smokers especially long-term smokers, most indexes of the pulmonary functions and all indexes of the small airway function correlated with smoking index. Conclusion Although smokers do not show clinical symptoms, their lung functions have been reduced, especially small airway function.

Objective To explore the differential proteins between livers of control and brain dead grups,and to provide an experimental basis for the assessment of liver quality in brain dead rabbits.Methods 60 healthy male New Zealand rabbits were divided into two groups.The brain dead group (n=30) contained rabbits 2 hours (B1),6 hours (B2),and 8 hours(B3) after brain death.The sham group (n=30) contained groups of 2 hours (C1),6 hours (C2),and 8 hours (C3).At the end of the relevant experiments,blood samples and liver tissues were collected.The level of ALT and AST were determined by an automatic biochemistry analyzer and the morphologic changes of the livers were detected by HE staining.The differentially expressed proteins were screened and identified by two-dimensional gel electrophoresis,PDQuest software,matrix-assisted laser desorption ionization time of flight mass spectrometry,and the NCBI database.Results In 8 hour brain dead group,the level of ALT increased comparing with 6 h (P＜0.05),but there was no significant statistical difference in the other groups.Under real time observation with the light microscope,the livers of the brain dead groups had increased edema and infiltration of lymphocytes in the portal area,especially in the 8 hour group.However,infiltration of neutrophils also appeared in the 8 hour control group and all groups had no damage in the liver cell.There were 10 kinds of differentially expressed proteins through the two-dimensional gel electrophoresis,mass spectrometry analysis,and database query.One protein of interest was ALDH2,which showed a gradually decreasing expression in the liver when the braid dead time increased.Conclusion Brain death could lead to no damage of liver function and little damage to liver morphology.The identified protein ALDH2 may be related with liver injury after brain death and could be a new indicator in the assessment of liver quality in brain dead rabbits.

Objective To explore the way to establish the brain death model for rabbits and pathophysiological changes before and after brain death.Methods 80 healthy male New Zealand rabbits were divided into brain death group (n =60) and sham operation group (n =20),The 60 brain death rabbits were established by increasing intracranial pressure in a modified,slow,and intermittent way.The sham operation rabbits were only maintained with anesthesia.Results The 56 brain death rabbits were established successfully and maintained for 10 h with the respiration and circulation supports.2 rabbits died due to anesthetic accident,the other 2 died because of improper pressure.The surgical success rate is 93.3％ (56/60).The changes of mean artery pressure (MAP) and heart rate (HR) in brain death group were more significant than in sham operation group:MAP and HR fluctuated and showed the increased tendency.The mean MAP and HR during increasing intracranial pressure were (400.24±18.36) mm Hg (1 mm Hg=0.133 kPa) and (258.00 ± 25.70) beats/min respectively,which was significantly higher than before and after increasing intracranial pressure (P＜0.05).Conclusions The brain death model for rabbits could be established by increasing intracranial pressure in a modified,slow,and intermittent way successfully and maintained 10 h.the MAP and HR before and after brain death showed characteristic changes.The model is helpful to the further observation of organ changes in brain dead state.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.