Objective To assess the value of fiberobronchoscopy in the diagnosis of endobronchial tuberculosis. Methods A total of 67 children suspected of endobronchial tuberculosis in our ward from March 2010 to December 2012 had been tested by chest CT and ifberobronchoscopy, mycobacteria culture, liquid-based interlayer vessel technique and FQ-PCR from bronchoalveolar lavage fluid and biopsy. Results 50 patients were clinically diagnosed as endobronchial tuberculosis. The positive rate of FQ-PCR (60%) and liquid-based interlayer vessel technique (42%) are higher than that of mycobacteria culture (20%), which showed no signiifcant difference with biopsy. The positive rate of the combined detection (FQ-PCR and liquid-based interlayer vessel technique) is significantly higher than that of mycobacteria culture and biopsy. Conclusions Fiberobronchoscopy is effective for the diagnosis of endobronchial tuberculosis.

Objective To explore the effect of exposure of the recurrent laryngcal nerve(RLN) in prevention of RLN injury during thyorid surgery.Methods The clinical data of 810 cases of thyroid operation in which the RLN was exposed in 252 cases(group A) and was unexposed in 558 cases(group B) were analyzed.Results Although the extent of thyroid resection was greater in group A than in group B,the rate of RLN injury in group A(1.19 %) was significantly lower than that of group B(3.05 %,P

Objective To observe the efficiency of clopidogrel combined with emergency corona interventional therapy for non-ST segment elevation myocardial infarction.Methods A total of 112 patients with non-ST segment elevation myocardial infarction who were admitted in our hospital from February 2004 to November 2007 were divided into 2 groups at random with 56 patients in each,the experimental group and the control group.All patients were treated with emergency corona interventional therapy and the other routine standard therapies.The experimental group was treated with clopidogrel(75 mg,once per day for 8 weeks),and the control group administered ticlopidine(250 mg,twice per day for 8 weeks).The two group were followed up for a time of half a year.Results The TIMI(thrombolysis in myocardial infarction) myocardial-perfusion grade 3 angiographic flow was achieved in 91.1% of the experimental group,higher than that of the control group(87.5%),but there was no significant difference between them.What's more,there was no obvious difference between the 2 group in cardiac functional grading and life-threatening bleeding.The experimental group had significantly lesser hyporrhea,and lower platelet degradation and total white blood cells counts in comparison to the control group.After the followed-up of half a year,there was significant difference between them in combination-end point.Conclusion Addition of clopidogrel is effective in emergency corona interventional therapy for non-ST segment elevation myocardial infarction,which can degrade the risk of emergency corona interventional therapy.

Objective: To study if there is an aryl-hydrocarbon receptor (AHR) expression in patients of pulmonary arterial hypertension associated with congenital heart disease (CHD-PAH) and to explore if the amount of AHR expression related to pulmonary vascular remodeling.
Methods:A total of 32 CHD-PAH patients diagnosed by echocardiography and right heart catheterization for surgical repair were enrolled, and the lung tissue biopsy was performed during the operation. The pulmonaryAHR was detected by immunolfuorescence assay, the ratios of vessel wall area/total area (WA/TA) and vessel wall thickness/vessel external diameter (WD/TD) of small pulmonary arteries were calculated with the imaging software, the mRNA expression of AHR, hypoxia-inducible factor-1α (HIF-1α), aryl-hydrocarbon receptor nuclear translocator (ARNT) and vascular endothelial growth factor (VEGF) were examined by RT-PCR. In addition, blood level of AHR was measured by ELISA.
Results: There was AHR expression in pulmonary tissue in all 32 patients. And AHR mRNA expressions were positively related to mPAP (r=0.809,P<0.001), WA/TA (r=0.723,P<0.001), WD/TD (r=0.746,P<0.001); and positively related to mRNA expressions of HIF-1α (r=0.889,P<0.001), ARNT (r=0.738,P<0.001), VEGF (r=0.822,P<0.001). Pulmonary tissue VEGF mRNA expressions were positively related to mPAP (r=0.739,P<0.001), WD/TD (r=0.702,P<0.001) and WA/TA (r=0.657,P<0.001). Blood levels of AHR were positively related to mPAP (r=0.754,P<0.001), WD/TD (r=0.754, P<0.001) and WA/TA (r=0.739,P<0.001).
Conclusion: AHR might be involved in pulmonary vascular remodeling in CHD-PAHpatients.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology* ; Creatinine ; Heart Failure/complications* ; Humans ; Hypertension, Pulmonary/complications* ; Nitrates ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Factors ; Stroke Volume ; Ventricular Function, Left