Objective To explore the causes,prevention and treatment of postoperative respiratory failure in patients with lung cancer.Methods The clinical data of 659 patients,admitted in Changzheng Hospital from Jan.2000 to Dec.2006,with lung cancer and suffered from postoperative respiratory failure were analyzed retrospectively.Preoperative lung function,past medical history,the etiology and preventive procedures,and the treatment methods for postoperative respiratory failure were also reviewed.Results Postoperative respiratory failure was occurred in 42 of 659 cases,the incidence was 6.4%,and all the 42 cases occurred in 1 to 5 days after operation.The major etiopathogenisis of postoperative respiratory failure included respiratory infection,bronchial asthma,operative wound,postoperative incision pain,preoperative cardiopulmonary dysfunction,etc.The respiratory failure was controlled in 37 of the 42 cases by mechanical ventilation and symptomatic treatment.Two cases died of multiple organ failure,another 2 cases died of respiratory distress syndrome and 1 case died of severe respiratory tract infection,the mortality was 11.9%.The preoperative lung function indexes of patients with postoperative respiratory failure were significantly lower than that of those patients without postoperative respiratory failure(P

Objective To report the surgical treatment results of cardiac and esophageal cancer of remnant stomach. Methods From 1980 to 2002, 30 patients with cardiac and esophageal cancer of remnant stomach were treated surgically. Results Primary cardiac and esophageal carcinoma of remnant stomach developed in male patients more than females. Of 30 patients, 21(70%) underwent subtotal gastrectomy with Billroth II reconstruction at first time. The mean interval between two operations was 13.5 years. Clinical symptoms frequently included abdominal distension, pain and hemorrhage. Thirty patients received radical resection. Conclusion Cancer in remnant stomach should be suspected in patients undergoing subtotal gastrectomy 5 years and over have clinical symptoms of upper gastrointestinal tract. Early diagnose and early curative resection should be done. For cardiac cancer of remnant stomach, total gastrectomy with “P” loops and Roux-en-Y esophagojejunostomy reconstruction were recommended. This procedure have advantage in retaining enough food storage preventing reflux esophagitis and allowing resection of esophagus long enough to avoid cancer remnant. For esophageal cancer of remnant stomach, colon reconstruction after the resection of esophageal cancer is recommended.

Objective To evaluate the diagnosis and therapy of solid pseudopapillary tumor of the pancreas (SPTP).Methods From January 2006 to October 2011,the clinicopathological data of 24 SPTP patients diagnosed and surgically treated at Tianjin Medical University Cancer Hospital were analyzed retrospectively.Results There were 22 women and 2 men,the median age was 27.5 years old,with a range from 12 to 51 years.The most common tumor localization were at the head of the pancreas ( 11 patients,45.7％ ),followed by the body (5 patients,20.8％ ),the tail (4 patients,16.7％ ),the body and the tail (3 patients,12.5％ ) and the neck (one patient,4.2％ ).Clinical symptoms were nonspecific and the preoperative diagnosis of SPTP depended on imaging study such as ultrasonography,CT and MR.All patients were treated surgically and the correct diagnosis was made according to pathology after surgery.In a follow-up ranging from 2 to 55 months( median 27.2 months),23 cases were alive with no evidence of disease recurrence,one patient was alive with tumor recurrence.Conclusions SPTP was a less common neoplasm with low-grade malignancy,occurring mainly in young women.Complete tumor resection results in satisfactory prognosis.

Objective To explore the influence of carbamazepine on the plasma homocysteine (Hcy),folic acid and vitamin B12 levels in the treatment of epilepsy.Methods The clinical medical history and medication com-pliance of 80 epilepsy patients were retrospectively analyzed.40 cases treated with carbamazepine were set as group A,another 40 cases without taking antiepileptic drug therapy were set as group B.And 40 cases in the same period in hospital physical examination were selected as control group.The levels of blood Hcy,folate and vitamin B12 were detected by using the fluorescent quantitative method,the electrochemical luminescence immunoassay,and the differ-ences of three groups of the levels were compared.Results The Hcy level of group A was significantly higher than the control group and group B(F =7.16,P =0.00),and the folic acid level of group A was significantly lower than the control group and group B(F =9.67,P =0.00).The Vit B12 concentration of group A was lower than the control group and group B,but among the three groups,the difference was not statistically significant(F =1.05,P =0.15). Loss of appetite and body weight decreased in 4 cases,2 cases of dizziness,fatigue,but symptoms were mild,did not affect the findings.Control in 13 cases,12 cases were markedly effective,effective in 8 cases,ineffective in 7 cases,the total effective rate was 82.5%.Conclusion Carbamazepine treatment can cause epilepsy patients blood Hcy level rise,and folic acid level drop,has no significant effects on the Vit B12 concentration,so in patients with epilepsy should pay attention to monitor blood Hcy and folic acid level during the treatment,in order to avoid adverse events such as thrombosis and influence the prognosis.

Objective To evaluate the practical value of 99m Tc-MIBI scintimammography and breast X-ray in the detection of breast cancer. Methods 100 female patients with 106 suspected focuses of breast cancer on clinical examination underwent 99m Tc-MIBI scintimammography and breast molybdenum target X-ray, and the results were compared with the pathological diagnosis. Results Compared with the histopathologic diagnosis , the sensitivity of molybdenum target X-ray for detecting primary breast cancer was 44.6% and the positive predictability was 31.7%. The specificity of 99m Tc-MIBI was 87.8% and the positive predictability was 76.9%. Conclusions In comparison with breast X-ray, 99m Tc-MIBI scintimammography is of greater clinical value in the diagnosis of breast cancer.

A 27-year-old woman was admitted to a hospital due to intermittent fever for 20+ days and swelling pain in knee joint for 7 days.Patients was with persistent fever,the highest temperature to 40.1°C,the double knee joint swelling pain,a large number of scattered red needle-like rash were visible on bilateral hands and legs,lymph-adenectasis,splenectasis,bilateral hands interphalangeal joint and knee joint swelling pain,lymph nodes were con-fined to the bilateral axillary with soft texture,local tenderness,and good activity.Pathological results of left axil-lary lymph node showed the following finding:fragmental lymph node tissue with incomplete structure,lymphoid follicles existed,there were diffuse histocytes,immunoblasts,and a few small lymphocytes proliferation in the re-duced or disappeared area of follicular,caryokinesis could be easily seen,there were patches of necrosis foci with varied size,nucleus disintegrated,fibrinoid necrosis blood vessel with bleeding could be seen.Immunohistochemical detection showed the following results:CD3 (diffuse +);CD20 (follicular +);CD79α(follicular +);CD68 (+);EMA (-);ALK (-);CD15 (a small amount of cells +);CD30 (+),CD4 (-),CD5 (+);CD10 (-);bcl-2 (+);CD21 (+);telomerase B (-);TIA-1 (-);EBV(-)Ki-67 (+).Through a combination of clinical and immunohistochemical detection results,the diagnosis of histiocytic necrotizing lymphadenitis was made.Patient discontinued antimicrobial drugs,after she was treated with 5% glucose 100 mL + hydrocortisone sodium succinate 200 mg intravenous drip for 3 days,patients had no fever,axillary lymph node gradually dwindled.Then patients was treated with methylprednisolone 8 mg/d,twice a day,reduced 1 tablet every two weeks,and stopped eventual-ly.Patients was followed up for two years,repeated examination of blood routine,liver and kidney function were in the normal range,bilateral knee didn’t swell,could walk freely,there appeared no enlargement of lymph node.

Objective To explore the relationship between enterprising and magnanimous psychological characteristics and coping modes in cancer patients.Methods Totally 450 cancer patients were randomly chosen to analyze the correlation using enterprising and magnanimous questionnaires and cancer coping modes questionnaires.T-test,Variance analysis and Pearson analysis were employed for statisticals.Results (1) The enterprising and magnanimous psychological characteristics:cancer patients generally got lower scores in the dimensions of enterprising,magnanimous,and total score (59.30±8.09,31.98±6.24,27.32±4.02,respectively) than healthy population (67.44±5.60,34.72±4.57,32.72±3.23,respectively).In demographic level,male and female cancer patients' scores were also lower than the healthy ones'.The higher academic backgrounds they had,the better enterprising and magnanimous psychological attitudes they embraced.In the comparison of occupation,professionals in administrative and companies scored the highest in the dimensions of enterprising,workers in special techniques,commercial and service industries scored higher in the dimensions of magnanimous.All the differences were significant statistically (P＜0.05).(2) Correlation analysis:the correlation index between psychological characteristics of enterprising and magnanimous and the coping modes in cancer patients was 0.463,with a positive correlation(P＜0.01),and the indexes among in the dimensions of enterprising and confrontation were regarded as a positive correlation (r=0.415),and negative correlations (r =-0.139,r =-0.047,respectively) with avoidance and suppression and resignation (P＜0.01).Conclusion The enterprising and magnanimous mental level of cancer patients is lower,which is related to their inappropriate responses of avoidance and suppression and resignation.

Objective To investigate the effect of plateau training on military operation ability ,evaluate the real situa-tion of combat forces on the plateau , and to provide data for effectively improving the combat effectiveness of the army stationed on the plateau .Methods According to the standards , the levels of high altitude acclimatization , physical work capacity (VO2max, PWC170) and mental work capacity (digit span, digit symbol, pursuit aiming and visual reaction time) were measured to assess the military operation ability of plateau training troops , including troops that entered the plateau from the plain(plateau-entering troops), troops stationed on the plateau (plateau troops) and troops stationed in the plain ( plain troops ) .Results The troops on the plateau all reached basic acclimatization .The aerobic capacities of these three types of troops were of the standard medium level , and the maximum oxygen uptake ( VO2max ) of the plain troops was greater than that of that of plateau-entering troops(P<0.01), and the VO2max of the plateau troops was greater than that of plateau-entering troops(P<0.01).Compared with the plain troops, the VO2 max and PWC170 of the plateau-entering troops decreased by 25.7%and 27.7%respectively.There was no significant difference in the digit span , digit symbol, pursuit aiming between these 3 kinds of troops , but the visual response of the plateau-entering troops was prolonged ( P<0.01), while the pursuit aiming of the plateau troops was lower than that of the plateau-entering troops(P <0.05). Conclusion Acclimatization-promoting measures and plateau training can contribute to high altitude acclimatization formation, but cannot overcome the objective adverse effects of the plateau on physical fitness .Two months of plateau training fails to improve physical fitness.Therefore, special attention should be paid to the research on scientific and effective measures to improve physical fitness on the plateau .

Objective:To investigate the association between rs1042713 polymorphisms of ADRB2 gene and the susceptibility of asthma in Chinese Population by meta-analysis.Methods: The Pubmed database,Emabase database,Web of Knowledge database, CNKI database,Wanfang database and Weipu database were searched for all publications about the susceptibility of asthma and the rs1042713 polymorphisms of ADRB2 gene in Chinese Population.The article which met the inclusion criteria were assessed by the STA-TA12.0 software.Results:12 studies were included,with 2 193 asthmatic patients and 2 033 controls.All the included articles were satisfied to the Hardy-Weinberg equilibrium.The results of Meta-analysis was showed that the risk of asthma of the mutations G carriers ( GG +GA) on ADRB2 gene rs1042713 loci in Chinese people compared with the wild-type homozygotes( AA) was not significantly in-creased overall(OR=1.08,95% CI=0.82-1.44).However,subgroup analysis showed that the risk of G carriers of children had a relatively higher incidence(OR=1.69,95% CI 0.99-2.87),while the risk of adult-onset have a relatively lower incidence(OR=0.88,95%CI 0.68-1.15).Conclusion:The ADRB2 gene rs1042713 polymorphisms have a certain correlation with the susceptibility of asthma in Chinese children,the mutant gene G carriers may relatively increase the risk of asthma in childhood.

Objective To investigate the application of capillary electrophoresis by dried filter blood paper for screening of α-thalassemia in neonates .Methods The hemoglobin (Hb) of 46 718 cases of neonatal dried heel blood spots were analyzed by the capillary electrophoresis and the content of HbA ,HbF ,HbA2 and abnormal Hb were detected ,the phenotype cases which was screened positive were recalled for genetic analysis .Results A total of 2 598 cases of Bart hemoglobin (Hb Bart′s) positive were detected in 46 718 cases of neonatal heel blood dried blood spots .The screening positive rate was 5 .56% (2 598/46 718) .A total of 477 cases of α-thalassemia gene carriers were confirmed by genetic analysis in the 544 cases which were recalled .The coincidence rate of Hb Bart′s screening and genetic diagnosis was 87 .68% (477/544) .By analyzing the relationship between the clinical pheno-types and the content of Hb Bart′s ,we found the Hb Bart′s content gradually increased with the severity of clinical phenotype ,and the difference was statistically significant (P= 0 .000) .Conclusion There is a good consistency between the capillary electrophore-sis of dried filter blood paper and the genetic analysis .It could be determined α-thalassemia clinical type according to the Hb Bart′s content .