Objective To study the efficacy and safety of pulmonary surfactant used in hyaline membrane disease(HMD)of newborn treatment.Methods 67 cases of HMD children were treated.And pulmonary surfactant was used by intratracheal instillation.Clinical manifestation,blood gas analysis,X-ray chest film and complication before and after treatment were observed and recorded.Results 65 cases of children were recovered and discharged(97.01％),while 2 cases were dead.The PO2 increased significantly after the surfactant was given(P＜0.05),while the PCO2 decreased significantly(P＜0.05),and situation of skin cyanosis was relieved.X-ray chest films in 24 hours showed that 62 cases were improved(92.54％),while 4 cases were not obvious(5.97％),and there was hemorrhage image in the last 1 caes(1.49％).There were 5 cases of complication,involving 3 cases of pneumonia,1 case of intracranial hemorrhage and 1 case of pulmonary hemorrhage.Conclusion Clinical symptoms could be impurved rapidly,pulmonary oxygenation could be ameliorated,the need of mechanical ventilation could be lower and the rate of incidence of complication and death could be reduced effectively by using pulmonary surfactant early.

Objective To evaluate the relationship between relative perfusion rate assessed with power Doppler imaging (PDI) and microvessel density (MVD), as well as expression of vascular endothelial growth factor (VEGF) in bladder carcinoma. Methods The transrectal ultrasound (TRUS) blood flow signal of bladder carcinoma was preoperatively detected with color Doppler imaging in 45 patients, and the relative perfusion rates were obtained for analysis. MVD and the expression of VEGF of excised tumor were assessed immunohistochemically. Results There were correlation between relative perfusion rate and MVD, the expression of VEGF. MVD and the expression of VEGF were related to pathologic grade and the invasiveness of tumor tissues. The expression of VEGF in bladder carcinoma was positively correlated to the tumor interstitial vascular density. Conclusion Combination of PDI and immunohistochemical parameters is useful for evaluating the angiogensis of bladder carcinoma from a different point of view.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system in the diagnosis of early esophageal carcinoma and precancerous lesions.Methods A total of 257 patients with suspicious esophageal lesions were examined successively by FICE,magnifying FICE,iodine dyeing endoscopy and magnifying iodine dyeing endoscopy.Findings were compared with the pathologic diagnosis.Results The positive rates of early esophageal carcinoma by FICE (92.6％,25/27) and iodine dyeing endoscopy (88.9％,24/27) were not significantly different (P =0.642),nor were those of magnifying FICE (96.3％,26/27) and magnifying iodine dyeing endoscopy (92.6％,25/27),(P =0.556).The magnifying FICE could reveal the IPCL of early esophageal carcinoma clearly.Early esophageal carcinoma and advanced neoplasia were mainly type Ⅳ + Ⅴ,low-level neoplasia and esophagitis were type Ⅱ + Ⅲ,and normal esophagus was type Ⅰ.However,the magnifying iodine dyeing endoscopy was not able to reveal IPCL.There was no adverse reaction in FICE,but the adverse reaction rate was 12.8％ (33/257) in iodine dyeing endoscopy.Conclusion Magnifying FICE can accurately determine the pathological types of early esophageal carcinoma,which is an effective complement to iodine dyeing endoscopy.

Objective To investigate the expression and clinicopathological features of matrix metalloproteinase 17 (MMP17) in gastric cancer.Methods The expressions of MMP17 at protein and mRNA level in 42 gastric carcinoma surgical specimens,42 endoscopic biopsy specimens of normal gastric tissue and 40 endoscopic biopsy specimens of atrophic gastritis were detected by immunohistoehemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively.Their relations with gastric clinicopathological features were analyzed.Chi square test,t-test and one-way ANOVA analysis were performed for comparing the differences between groups.Results There was no statistically significant difference(P＞0.05) in the expression rate of MMP17 between 42 specimens of normal gastric tissue(7.1％,3/42) and 40 specimens of atrophic gastritis (10.0％,4/40),however both were significantly lower than that of gastric carcinoma (73.8％,31/42,x2 =38.74,34.10,both P＜0.05).The expression quantity of MMP17 at mRNA level of 42 specimens of normal gastric tissue and 40 specimens of atrophic gastritis was 0.226 ± 0.032 and 0.254 ± 0.074 respectively,there was no significant difference(P＞0.05),however both were lower than that of gastric carcinoma (0.476±0.043,t=8.079 and 4.493,both P＜0.05).The expressions of MMP17 at protein and mRNA level were related to depths of invasion,lymph node metastasis and serous membrane involvement in gastric carcinoma patients (x2 =5.300,5.054,4.438,t =2.437,2.372,2.203,all P＜0.05),but not correlated with age,gender,lesion length,lesion site and histological grade (all P＞0.05).The positive rate of MMP17 expression in patients with survival time less than 2 years was significantly higher than that in patients with survival time over two years (x2 =12.71,P＜0.05).Conclusions In gastric carcinoma tissues,the expression of MMP17 increased along with the progression of gastric carcinoma.The detection of MMP17 may have some clinical reference value in determining the prognosis of gastric cancer patients.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system for determine the margin of early gastric cancer and precancerous lesions.Methods From February 2008 to October 2011,a total of 51 patients with early gastric cancer or high-grade intraepithelial neoplasm who received ESD were enrolled and randomly divided into experimental group to determine lesion margin by FICE (n =26) and control group to identify lesion margin by indigo carmine (n =25).Histological complete resection rate (the lateral and vertical margins were free of cancer),operation time,complications,post-ESD ulcer-healing rates and local recurrence were assessed.Results The histological complete resection rate,acute minor bleeding rate and post-ESD abdominal pain rate in experimental group were 2.3％ (24/26),88.5％ (23/26),15.4％ (4/26) and 73.1％ (19/26),which were not significantly different from those of control group,i.e.,92.0％ (23/25),84.0％ (21/25),12.0％ (3/25)and 72.0％ (18/25) (P＞0.05).The mean operation time of in experimental group was shorter than that of control group (P ＜ 0.05).No massive bleeding,delayed bleeding or perforation occurred in either group.Follow-up showed no local residue or recurrence.Conclusion FICE is safe and effective to determine the tumor demarcation of early gastric cancer and high-grade intraepithelial neoplasm,and needs less operation time.

ObjectiveTo evaluate the Fuji intelligent chromo endoscopy (FICE) in the diagnosis of Barrett esophagus (BE).MethodsFrom September 2010 to March 2011,a total of 180 patients with suspected reflux esophagitis were examined successively by FICE,magnifying FICE,acetic dyeing endoscopy and magnifying acetic dyeing endoscopy.The diagnosis was made out under the observation of lesion extensions,superficial mucosa contrast ratio,pit patterns and capillary forms of BE.The endoscopic diagnosis was made and compared with the pathologic diagnosis,and the consistency of the diagnosis was evaluated by Kappa value.ResultsBE was confirmed in 35 patients ( 19.4％ ) pathologically.The consistency rates of diagnosis under FICE and acetic dyeing endoscopy were 81.7％ and 72.8％ ( P ＜ 0.05 ).The consistency rates of diagnosis under magnifying FICE and magnifying acetic dyeing endoscopy were 97.8％ and 85.6％,respectively (P ＜ 0.05).FICE magnifying endoscopy revealed better mucosal structures of capillaries than magnifying acetic dyeing endoscopy did ( P ＜ 0.05 ),but there was no significant difference in revealing of duct openings (P ＞ 0.05).The specificity,sensitivity,positive predictive value,negative predictive value and Kappa value of FICE in diagnosis of BE were 82.1％,80.0％,51.9％,94.4％ and 0.52,respectively,which were 73.2％,71.4％,39.1％,91.4％ and 0.34 of acetic dyeing endoscopy,98.6％,94.3％,94.3％,98.6％ and 0.93 of magnifying FICE,and 88.3％,74.3％,60.5％,93.4％ and 0.58 for magnifying acetic dyeing endoscopy.ConclusionAs a neotypical endoscopic system,magnifying FICE could exhibit clearly the pit patterns and microvascular structures of esophagus mucosa,and it can capture the optimal images of Barrett's epithelium.FICE could improve the diagnosis of BE in vivo.

ObjectiveTo explore the clinical effects of forearm cutaneous neurovascular flaps to be used on repairing remote wound.Methods17 cases of soft tissue defect of head and facial region and upper extremity were repaired with forearm cutaneous neurovascular flaps.Results The flaps of 16 cases were entirely survived, partial necrosis appeared in 1 case and healed after changing dressing.Following up for 3 to 6 months, the quality and shape of all the flaps and function recovery of all patients were satisfied.ConclusionsWith adequate blood supply, the survival rate of forearm cutaneous neurovascular flaps is high and the procedure to repair remote wound is easy, and it is one of best ways to repair the soft tissue defect in head and facial region and upper extremity with forearm cutaneous neurovascular flaps.

Objective To research the early effects and side-effects of the local advanced nasopharyngeal carcinoma patients using intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy.Methods From January 2005 to January 2007,60 patients with nasopharyngeal carcinoma of stage m-IV b were received IMRT combined with concurrent chemotherapy in our center.Sixty patients were divided into paclitaxel concurrent group(32 patients)and cisplatin concurrent group(28 patients).The prescribing doses of the primary tumor were 68-72 Gy for each group.The patients of paclitaxel concurrent group patients of the cisplatin concurrent group got earlier radiodennatitis and radiation-induced mucositis but also got significantly higher rate of radiodermatitis,radiation-induced mucositis,radiation-induced leucopenia and gastrointestinal toxicity,as well as the loss of weight.No significant difference was found on liver and renal funcfons between two groups.Four patients(12.5%)of the paclitaxel concurrent group were broken-off,which was much better than the cisplatin concurrent group.There was no significant difference on the specific length of break-off time,the 2-year overall survival rate and the 2-year diseaee-free survival rate between two groups.Conclusions IMRT combined with concurrent chemotherapy of paclitaxel liposome for local advanced nasopharyngeal carcinoma results in less side-effects and better tolerance than IMRT combined with concurrent cisplatin chemotherapy.

In order to find out the social attitude towards euthanasia and related issues,we conduct a questionnaire investigation on medical staff,patients,medical school students,and community groups in Beijing.From the survey,we find out that there is a relatively high degree of awareness of euthanasia,and the different attitudes for euthanasia are relevant to the educational backgrounds and professional backgrounds.In addition,by analyzing the mentality of people talking about the death,we find out that people with a healthy outlook on life and death are more inclined to agree with active euthanasia.

Background and purpose: Triple negative breast cancer (TNBC) is a high risk breast cancer characterized by the negative expression of estrogen receptor(ER), progesterone receptor (PR) and Her-2 that have no specific therapy. This study was to analyze clinical pathological characteristics, survival, and prognostic factors of patients with TNBC. Methods: Clinical and pathological as well as follow-up data of TNBC, treated at the Cancer Centre of Sun Yat-sen University from Jan. 2000 to Dec. 2003, were collected and analyzed. Results: A total number of 128 women were identified as having triple negative breast cancer. The median age of these patients was 46 years, and 60.9% of them had stage Ⅰ or Ⅱ disease. The majority of pathological types were invasive ductal carcinomas, and 78.1% of tumors were staged T1 or T2. And 48.4% of these patients were involved in lymph node. Event-free survival, local replase-free survival, distant metastasis-free survival and overall survival at five years were 71.1%, 84.3%, 75.8% and 83.6% respectively. Though lymph node metastasis, tumor masses, stage and lymph-vascular invasion were all found to be related to overall survival, however, only lymph node metastasis and tumor masses affected the overall survival as revealed by the Cox proportional hazard model analysis. Conclusion: Triple negative breast cancer has distinct clinical and pathological characteristics. The patients are usually young, with large masses, lymph node metastasis, family history of breast cancer and poor prognosis; lymph node metastasis and tumor mass are important prognostic factors.