Sixty-four patients with solitary pulmonary nodules were included in this study. The diameter of pulmonary nodules was equal or less than 3.0 cm and no contact with the adjacent pleura. They were divided into study group( with acuductor locating method)and conventional group (with conventional method). The results showed that the one-time success rates were 97％ (31/32)in study group and 72％(23/32) in conventional group, the diagnostic accuracy were 94％ ( 30/32 ) and 88 ％ ( 28/32 ), respectively,while the successful puncture time were( 13. 5 ±4. 9)min and( 18. 7 ±5. 7) min, respectively. In study group,the complication rate was 9％ (3/32), while 28％ ( 9/32 ) in conventional group. There were statistical differences between the two groups. CT-guided aspriation biopsy for solitary pulmonary nodules with self-made acuductor can obviously improve one-time success rate and reduce the complication rate and operative time.

Objective To study the liver X receptor(LXR)and the gene expression of cholesterol ester transfer protein(CETP),cyclooxygenase-2(COX2)in obstructive sleep apnea hypopnea syndrome(OSAHS)patients.Methods Macrophages were separated from the blood drawn in 30 cases of OSAHS patients and 30 healthy control subjects in the morning,RT-PCR gel eletrophoresis was used to determine the patterns of gene expression.Results OSAHS patients had higher LXR,COX2,CETP expression(P

Iatrogenic traumatic biliary stricture is one of the difficult points in the biliary surgery,and operation is the only definitive treatment. The operative opportunity,surgical procedure and techniques are important for the prognosis.From January 1998 to December 2011,173 patients with iatrogenic traumatic stricture were admitted to the Eastern Hepatobiliary Surgery Hospital. According to the Bismuth classification of traumatic biliary stricture,10 patients were in type Ⅰ,22 in type Ⅱ,87 in type Ⅲ,38 in type Ⅳ and 16 in type Ⅴ.Excision of the traumatic stricture with end-to-end anastomosis was performed on 19 patients.Of the 173 patients,154 were treated by Roux-en-Y duodenojejunostomy, and 8 of them received additional hemihepatectomy or partial hepatectomy.A total of 155patients were followed up,with a median time of 74 months,the total excellent and good rate was 94.8％ ( 147/155 ).Surgery is the most effective therapy for iatrogenic traumatic biliary stricture. Optimal timing, reasonable surgical methods, strictly following the principle of biliary surgery and perfect operative skills are key points for a better prognosis.

Objective To investigate the value of immunophenotypes in pathologic diagnosis of follicular lymphoma (FL) and the differential diagnosis between neoplastic follicle (NF) and reactive hyperplastic follicle (RHF).Methods 50 cases of FL and 10 cases of RHF as control were studied by clinical data, the expressions of CD20, bcl-2, CD3, CD10, bcl-6, CD21 and Ki-67 were detected by EnVision immunohistochemical method for the immunphenotypical pattern of FL and RHF.Results Among 50 FL cases , there were 24 male cases and 26 female cases, with median age of 50 years old (10-80 years old), including 32 cases (64 ％) involved predominantly neck lymph nodes.The histologic grades were 1-2 in 16 cases (32 ％) and ≥3 in 34 cases (68 ％).CD20, CD10 and bcl-6 were positive in NF tissues of FL, with irregular forms of NF and loss of the mantle area without clear demarcation, and infiltrating to NF, irregular shape and no clear perimeter.The bcl-2 was positive in all of grade 1-2 NF, and it was positive in 68 ％ (23/34) cases and was partial or total negative in 32 ％ (11/34) cases in grade≥3 NF.Those were poorly demarcated contours.The Ki-67 proliferative index of NF were ＜30 ％ in grade 1-2, and ＞30 ％ in grade ≥ 3, with the highest to 90 ％.In FL, the CD21 staining result showed follicular dendritic cells (FDC) network were synchronized with NF, and in some cases of grade ≥ 3, the FDC network were ruptured.In RHF, the CD20 was positive for round or oval nodules with clear demarcation.The CD10, bcl-6 and CD21 were positive and bcl-2 was negative in all germinal center without invasive immunophenotype.The Ki-67 index was high in germinal center, and sometimes polarity may be seen.Conclusion The immunophenotypical differences between FL and RHF include invasive characteristics, loss of follicular mantle area and germinal center pattern in the NF, while the normal follicular immunophenotype in the RHF.

Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.

A total of 218 patients on chemotherapeutic regimens containing oxaliplatin were randomly divided into experimental (n =120) and control (n =98) groups.The experimental group received an intravenous infusion of lipoic acid plus sodium potassium magnesium calcium and glucose injection.The control group had only normal saline.Overall incidence of neurotoxicity and toxicity grade of peripheral nerve were observed after 4,8 and 12 cycles.Those with neurotoxic symptoms were followed up for 1 year.No significantly statistical difference existed in the incidence of peripheral neurotoxicity after 4,8 cycles (P ＞0.05).After 12 cycles,31 patients in the experimental group had an onset of neurotoxicity of grade3 (n=8,6.7％) &grade4 (n=0) versus21 cases of grade3 (n=21,21.4％) and grade4 (n=5,5.1％) in the control group.Statistically significant differences existed between grades 3 and 4 neurotoxicity (P ＜0.05).After 1 year of follow-up,the incidence of grade 1 of neurotoxicity was 2.5％ (n =3) in the experimental group versus 23.7％ (n =9) in the control group.And the inter-group difference was statistically significant (P ＜ 0.05).Lipoic acid plus sodium potassium magnesium,calcium and glucose injection can effectively prevent the occurrences of acute and chronic peripheral neurotoxicity associated with oxaliplatin.

Objective To summarize the experience of early management in elderly patients with serious burning in order to raise cure rate. Methods Elderly patients (63 cases) with serious burning (burned area exceeding 30% or Ⅲ? area exceeding 10% ) admitted from 1990 to 2002 were retrospectively studied. Patients were divided into two groups according to the admission date, before and after January 1, 1996 since new management was extensively applied after 1996. These measures consisted of rapid and adequate fluid resuscitation, early enteral feeding and autograft after eschar excision. Results The incidence of sepsis and MODS was 38.7% and 19.4% respectively after 1996. It was evidently lower than the group before 1996(65.6% vs 43.8%, P

Objective To study the effect of low frequency on drug release from improved PLGA microcapsules, and investigate the possibility of utilizing PLGA microcapsules as the carrier of ultrasound targeted drug delivery system to deliver drug into brain. Methods Doxorubicin loaded poly (D,L lactic-co-glycolic acid) (PLGA) microcapsules were prepared via double emulsion solvent evaporate method and coated with either chitosan or gelatin. In vitro drug release profile and the drug release rate under the exposure of low frequency pulsed ultrasound (25 kHz) and continuous wave ultrasound (35.1 kHz) were assayed. Results The coating with chitosan or gelatin can depress the burst of drug release. The drug release rate from uncoated and chitosan-coated microcapsules did not changed with the exposure of ultrasound, and the rate of gelatin-coated microcapsules did increased. The effect of pulsed ultrasound was stronger than that of continuous ultrasound. Conclusion The drug release from gelatin-coated PLGA microcapsules can be controlled and triggered by 25 kHz pulsed ultrasound, which may be a potent carrier of targeting drugs into brain.

Objective To study the effect of human cytomegalovirus (HCMV) on expressions of K8 and K18 in duct epithelial cells of salivary gland. Methods The expressions of immediate early antigen of HCMV, K8 and K18 were detected by immunohistochemistry staining in tissues embedded in paraffin of parotid cytomegalic inclusion disease(PCID). Results Cytomegly bearing inclusion appeared in duct epithelium of PCID. DDG9/CCH2 antigen of HCMV was expressed in cytomegly bearing inclusion. K8 was negative in these cytomegly while K18 was intensively positive. Conclusion It is suggested that breaking down of K8 be induced in parotid duct epithelial cells infected by HCMV and that up-regulation of K18 may be a reactive change. Keratin network in simple epithelium functions to impart mechanical integrity to cells.

Objective To characterize the clinical features and assess the role of surgery in posterior cortex epilepsy. Methods A retrospective analysis of clinical data was performed in 43 patients with posterior cortex epilepsy. The diagnosis Was established by means of a standard presurgical evaluation, including ictal semiology, MRI, interictal and ictal scalp video-EEG, and additional intracranial EEG monitoring in selected cases. Results The 43 patients included 11 parietal lobe epilepsy, 13 occipital lobe epilepsy, and 19 patients with seizures originating from other part of posterior cortex. Thirty-three patients (76.7%)experienced at least one type of aura, such as visual aura, somatosensory aura, dizziness and so on. The common ictal manifestations included deviation, automatisms, tonic posture and so on. Intracranial EEG monitoring was preformed in 22 selected cases. Transient contralateral hemiparesis occurred in 2 patients, mixed aphasia in 1 patient, and they recovered in 3 weeks after surgery. Visual and visual field deficits were observed in 5 patients, and they did not fully recovered. All patients were followed-up 1 to 5 years, and 27(62.8%)became seizure free (Engel' S I class). Conclusions Some of the specific auras or ictal manifestations may indicate posterior cortex epilepsy. Favorable surgical outcome has been achieved in many of the patients.