Objective To investigate the expression and clinical significance of thyroid transcription factor-1(TTF-1)and chromogranin A(CgA)in small cell lung cancer(SCLC). Methods The expressions of TTF-1 and CgA protein in 68 cases of SCLC tissues and 20 cases of normal lung tissues were examined by immunohistochemistry method,and their correlations with clinical features of SCLC were analyzed. Results The positive rates of TTF-1 and CgA protein in SCLC were 88. 2%(60 / 68)and 70. 6%(48 / 68),respec-tively,and they were higher than those in normal lung tissue[10. 0%(2 / 20)and 5. 0%(1 / 20);χ2 = 45. 442, P = 0. 000;χ2 = 26. 941,P = 0. 000]. The expression of TTF-1 protein was not related to the patients' age,sex and tumor size,while closely related to smoking index(χ2 = 4. 131,P = 0. 042),lymph node metastasis(χ2 =5. 488,P = 0. 019)and clinical stage(χ2 = 6. 011,P = 0. 014). The expression of CgA protein was not related to the patients' age,sex,tumor size and smoking index,while closely related to lymph node metastasis(χ2 =9. 895,P = 0. 002)and clinical stage(χ2 = 4. 145,P = 0. 042). Conclusion TTF-1 and CgA protein are highly expressed in SCLC,especially in the patients with lymph node metastasis and extensive disease.

China ; epidemiology ; Humans ; Pneumoconiosis ; epidemiology

Objective To explore the changes of interleukin-13(IL-13) and total immunoglobulin E(IgE) levels in children with stable asthma.Methods Eighty-eight cases of children with asthma in remission stage aged 6-14 years old and 40 normal children were involved in this study.The concentrations of serum IL-13 and total IgE were measured with enzyme linked immunosorbent assay(ELISA) method and UniCAP pharmacia system.Results Clinical evaluation and lung function were improved in asthmatic children.Serum IL-13 level of asthmatic children in remission stage was higher than that of control group(U=3.93 P0.05).Conclusions There exists continuous allergic inflammation for children with asthma in remission stage.The high concentrations of serum IL-13 and IgE are associated with immune pathological mechanisms of asthma.

Objective To explore the atopic condition of children with stable asthma and their parents by detecting total IgE concentration in serum and collecting history. Methods Fifteen children with asthma in remission stage and 24 parents and 40 normal children were involved in this study. The concentrations of serum total IgE were measured with UniCAP Pharmacia system. The history including eczema and allergic rhinitis and asthma of children and parents were collected. Skin test with 10 kinds of inhalant allergens were taken in children with asthma. Results Of 15 children with asthma, 13 cases (86.7%)had eczema in infant stage and allergic rhinitis, 13 parents(86.7%)had allergic rhinitis or asthma. There was significant difference in the stable asthmatic children compared with parents and normal control group increased amounts of serum total lg IgE(F=68.42 P=0). There was significant difference in serum total lg IgE in patients group(2.43?0.73)kU/L compared with that in normal control group(0.72?0.54)kU/L (q=14.176 P0.05). Twelve children were positive in skin test, which were mainly dermatophagoides pteronyssinus and dermatophagoides farinae.Conclusions There is obvious congregate phenomena of atopy in the family of asthmatic children. The continuous high IgE concentration was associated with immune pathological mechanisms of atopic diseases.

Objective To explore the changes of Clara cell secretory protein(CCSP) in asthmatic children and the effects of inhaling glucocorticoid (ICS) on CCSP.Methods Sixty children with asthma were selected as asthma group(in which 39 cases were male and 21 cases were female,aged 3-12 years old) and 30 healthy children were selected as healthy control group(in which 20 cases were male and 10 cases were female,aged 3-12 years old).Venous blood samples were collected in asthma group and healthy control group in morning before breakfast,and then sera were obtained by centrifuge in speed of 1 500 r?min-1 in 10 min.The dynamic levels of CCSP were measured in sera by enzyme-linked immunosorbent assay.Results 1.In asthmatic children,the CCSP levels in acute episode,3 months after ICS,6 months after ICS, and 12 months after ICS[(5.140?2.331)?g?L-1,(8.730?3.392)?g?L-1,(10.510?2.813)?g?L-1]were all lower than that in healthy control group[(13.230?4.010)?g?L-1](Pa0.05).2.Compared with acute episode,the patients who ICS for 3 months,6 months and 12 months had significantly higher levels of CCSP (Pa0.05).Conclusions CCSP may play a protective role in the airway inflammation of asthma.Glucocorticoid may increase CCSP level in asthmatic children.Glucocorticoid and CCSP may cooperate in anti-inflammation in airway of asthmatic children.

Objective To explore the role and clinical significance of interleukin-6(IL-6) in children with bronchial asthma.Methods Sera were collected from 29 cases with asthmatic attacks,32 asthmatic children who in stable conditions,and 20 health children.Serum IL-6 concentrations were measured by radioimmunoassay(RIA).Results 1.Asthmatic children appeared significantly higher levels of serum IL-6 during asthmatic attacks as compared to those in stable conditions and healthy ones respectively(P3 years old had significantly higher serum IL6 concentrations than ≤3 years old children in remission.Conclusion IL-6 may participate pathogenesis of asthma,and it may play different biological roles during asthmatic attacksas or stable conditions.

Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were injuryed in traffic accidents.The areas of free anterolateral thigh flaps were 8 cm × 5 cm to 18 cm × 12 cm.All the patients begined to early rehabilitative exercise under the protection of orthosis after 2 weeks of the operation.Results All cases were followed up from 6 to 24 months,averaged of 14 months.All the flaps survived,and only 2 cases with necrosis of small area in distal,and which were healed by dressing.The healing time were 12 to 24 days,and the average of 15.1 days; The surgery function were assessed according to Thermann's scale,and the results was 14 cases for excellent,9 cases was good,the general was 2 cases,and the excellent and good rate was 92％.Conclusion The transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defect at foot and ankle and functional reconstruction is a safe and effective strategy,and it has the advantages such as covering the wound at foot and ankle approvingly,reconstruction of power device once,the flap and iliotibial band were in the same wound,the trauma of doner site is small invasive,early recovery functional exercise,shorten the treatment cycle,and relieve the suffering of children.

Objective To investigate the clinical effect of primary internal fixation combined with flap transfer for Gustilo Ⅲ B open fracture of lower extremity with severe soft tissue defct.Methods From January,2008 to January,2013,15 patients with Gustilo Ⅲ B open fracture of lower extremity and severe soft tissue defect were treated with primary internal fixation combined with flap transfer.Among them,there were 2 cases of foot and ankle fracture,9 of lower-tibia and fibula,3 of upper-tibia and fibula and 1 of distal femur fracture.The areas of the flaps were 10 cm × 8 cm-28 cm × 16 cm.Three cases were treated by bone grafting because of bone defect.Results All patients were followed up for 6-24 months.All flaps were survived,and only small area of 2 cases with the distal necrosis were cured by changing the dressing; In 1 case,the wound was infection and healed after anti-infective and drainage treatment; 13 cases had bone union in primary stage,and the other 2 cases were achieved delayed union; the average healing time was 7.2 months,and no case of osteomyelitis was noted; the time of wound healing was 12-36 days,with an average of 18.1 days.According to lower extremity function evaluation form,the excellent and good rate was 86.6％.Conclusion It is a safe and effective strategy to treat the Gustilo Ⅲ B open fractures of lower extremity and severe soft tissue defect with primary internal fixation combined with flap transfer,which has advantages of reliable fixation,covering the wounds with satisfaction,recovering exercise early,shorten the treatment period,alleviating the suffering of patients and so on.

Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.

Objective To investigate the clinical effect of harvesting the free anterolateral thigh flap irregularly for the repair of the multiple and complex skin and soft tissue defect at lower limb.Methods From January,2009 to January, 2014, 7 patients with multiple and complex skin and soft tissue defect at lower limb were treated with transplantation of the free anterolateral thigh flap with harvesting irregularly.The parts of wound defect: 2 cases of medial leg andlateral leg, 3 cases of foot back andankle, and 2 cases of medial malleolus and lateral malleolus.All the cases were operated in fracture fixation and wound without obvious infection.The vascular pedicle of free flaps were descending branch of lateral circumflex femoral artery.The types of the harvesting the free anterolateral thigh flap irregularly: 3 cases of the anterolateral thigh flap and terminal branch of lateral femoral circumflex artery muscle flap, 2 cases of the anterolateral thigh flap and transverse branch of lateral circumflex femoral artery muscle flap, and 2 cases of reconstructed lobar femoral anterolateral thigh perforator flap (vascular anastomosis of pedicle of lobulated anterolateral thigh perforator flap with the main stem branch artery of the lateral femoral circumflex vessels).The area of harvesting the free anterolateral thigh flap irregularly were 6 cm × 4 cm to 16 cm × 12 cm;The donor site were closed directly.All the patientsbegined to early rehabilitative exercise under the protection of orthosis after 4 weeks of the operation.Results All cases were followed up for 6 to 14 months, and the average of 8.2 months.All the flaps survived, besides 2 cases with necrosis of small area in distal, and which were healed by dressing, debridement,skin grafting and so on;The healing time were 12 to 34 days, and the average of 17.1 days.The area of flaps without obvious retraction, color were the same as the region, no obvious scar contracture.Conclusion The anterolateral thigh flap feed by the same source vessels for the repair of the multiple and complex skin and soft tissue defect at lower limb is a safe and effective strategy.The flap can be combinated differently to repair multiple and irregular wound one-time, the donor site is small invasive, shorten the treatment cycle, and relieve the suffering.