Objective To analyze the clinical diagnosis and therapeutic effect of primary middle lobe lung cancer,in order to provide evidence for clinical diagnosis and treatment.Methods The clinical data of 45 cases of primary middle lobe lung cancer treated by surgery from January 2002 to January 2007 were ana- lyzed retrospectively.The operation style includes:simple middle lobectomy 12 cases(26.7 %),middle or up- per lobectomy 10 cases(22.2 %),right lung total resection 5 cases(11.1%).Chest exploration was done on 2 cases(4.44 %),palliative resection or vedged resection 2 cases(4.44 %).Results 1 case died from lung in- fection and respiratory failure(2.22 %).15 cases with arrhythmia (33.3 %), 1 case with chylothorax were cured after conservative treatment.The survival rate of 1,3,5 year were 82.1%,64.3 %,32.1% respectively. Conclusion The treatment of primary middle lobe lung cancer is dominated by regular lobectomy. It is difficult to perform middle lobectomy,so double or total lobectomy is done generally.Owing to the more postoperative complications, it should be cautious to perform sleeve resection.It should be avoided to do vedged resection for primary middle lobe lung cancer in order to lessen local recurrence.

Objective To investigate the feasibility and clinical effects of suture anchors technique for acute distal avulsion fracture of patella. Methods From January 2007 to July 2009, 33 patients(18males and 15 females, ranging from 28 to 72 years, with an average of 49.3 years) were treated with the suture anchors technique. The average time from injury to surgery was 3.5 days(2 to 7 d). Injury reason: traffic accident in 12 cases, injured in daily life in 11 cases, sports injury 9 cases, no clear trauma history in one case. The Bostman evaluation system, follow-up X-ray, and knee mobility were used to analyze the clinical effects of suture anchors technique. Results All patients obtained the follow-up and the average time was 16.5 months(12 to 23 months ). One patient suffered foreign body reaction, and his wound healing was good after operation. The remaining patient wound healing was good. No complications were found in all patients,such as popliteal fossa artery, tibial nerves or peroneal nerve complication. Bostman patella fracture functional score 27.3±2.3 points at the sixth months follow up, 28 cases were rated as excellent, 5 cases were good, and the excellent and good rate was 100%. Six months later, X-ray showed bone healing, knee activity recovered well. The Range of Motion was extension for -2.5°±2.1° and flexion for 122°±5.3°. Conclusion Suture anchors fixation in treatment of acute distal avulsion fracture of patella has a good efficacy, safety and reliability advantages, and without the second operation. This technique provides an alternative in lower pole patella fracture.

Objective To evaluation the comprehensive acquired immunodeficiency syndrome (AIDS) intervention program conducting in men who have sex with men (MSM) population living in Inner Mongolia Autonomous region. Methods A comprehensive intervention program was carried out among MSM groups in Hohhot and Baotou City. Seven hundred and six and 767 MSM were enrolled for investigation through the snowball method during May 2008 and May to June 2009, respectively.At the same time, 5 mL intravenous blood sample was collected from each subject for human immunodeficiency virus (HIV) detection and intervention effect evaluation. Data were analyzed by x2test. Results After intervention, the awareness rate of HIV/AIDS knowledge increased from 70.7%(499/706) to 81.7%(627/767) (x2 =25. 004, P＜0.01 ). The rate of consistent condom use in the last six months increased from 38.0%(254/668) to 45.3% (346/764) (x2=8. 269, P＜0. 05). The percentage of subjects who had more than 5 different male sexual partner during the last 6 months significantly decreased from 42.8% to 24.6% (x2 = 55. 348, P＜0.01). The median number of sexual partners in MSM decreased from 3 in 2008 to 2 in 2009. The HIV infection rate was 1.7 % in both 2008 and 2009. Conclusion The comprehensive intervention program among MSM population shows positive influence after one year implementation, which is helpful for increasing HIV/AIDS awareness and safe sex behavior in this population.

Objective To observe the effect of epidural injection with different dose of butorphanol on the rats' neurological function.Methods A PE-530 catheter was inserted into the epidural space of all the SpragueDawley rats (male, weighting 180 ～210 g) at L1-2 level.After three days, a total of 32 rats without any motor dysfunction were randomly divided into 4 groups as follows saline(NS) group (group C, n= 8 )and butorphanol injection (B) group( B1∶ n=8;B2∶ n=8;B3∶ n=8).Rats in group C were epidurally injected NS 30 μl each ,and rats in group B1, B2 and B3 were respectively epidurally injected Butorphanol 60 μg/30μl, 120 μg/30 μl,240 μg/30 μl (all diluted with NS) ,and 1 time per day for5 days.The neurological function of rats was recorded before injection (T0) and 6h after injection on day 1 ～4(T1 ～T 4) and 6h,24h and 72h after injection on day 5 (T5 ～T7) by BBB (BASSO,BEATTIE and BRESNAHAN ) Score and the inclined plane test .Results Compared with group C ,the BBB score and the inclined plane test of group B1 showed no significant difference throughout the experimental period(P＞ 0.05 ).There was also no significant difference at T0 ～ T3 of group B2 and group B3 compared with group C (P ＞ 0.05 ), while at T4, the BBB score ( ( 18.50 ± 2.00 ) points, ( 16.38 ± 2.33 ) points) and the inclined plane test( (58.75 ± 5.17 )°, (59.38 ± 3.20) ° ) of the two groups were both obviously decreased when compared with group C( (21.00 ±0.00) points, (65.00 ±3.78)°, P＜0.05) ,and the same significant differences appeared at T5,T6 and T7 (P ＜ 0.05 ).Conclusion Repeated epidural injection of butorphanol 60 μg have no effect on neurological function of rats,while repeated epidural injection of butorphanol 120 μg and 240 μg could impaire the neurological function.

Objective To observe the effect of a novel pressure controlled water jet used in transurethral resection of bladder tumor. Methods Clinical data of 12 patients who underwent a transurethral resection of bladder tumor by using a novel water jet was retrospectively analyzed. Results All 12 cases were successfully operated. Estimated blood loss during operation was less than 5 ml. Operation time was 20-45 minutes (median was 28 min), time of water injection was 8-15 minutes (median was 12 min). There were no significant complications. All patients were followed up for 4-10 months, and tumor recurrence or progression was not found by cystoscopic examination. Conclusion Transurethral resection of bladder tumor by using a novel pressure controlled water jet is advantageous with favorable safety and feasibility.

In order to provide substantial scientific information for exploring the mechanism of porcine liver injury caused by Taenia asiatica (T.asiatica),the expression of Cysteine aspartyl proteinase 3 (Caspase-3) from liver tissues of porkets that were experimentally infected by T.asiatica was examined.The T.asiatica adults were collected from the taeniasis patients in Duyun,Guizhou Province and identified biologically.The eggs were harvested from gravid proglottids and prepared by repeated washing and centrifugation.Twelve 20-days old Yorkshire and Seghers hybrid porkets were randomly divided into experimental and control groups as six pigs per group.The experimental group was orally administrated with 1.5 × 106 eggs per porket at day 0 post-infection.The porkets of both groups were sacrificed on the day 15 and day 75 post-infection (three pigs per time point) respectively,and liver samples were collected for further experiments.Quantitative real-time polymerase chain reaction method was employed to detect the mRNA levels of Caspase-3,and western blotting and immunohistochemistry methods were performed to detect the level of Caspase-3 expression in both groups.At the day 15 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were significantly decreased,comparison with the control group (P =0.011,P=0.008 and P=0.004 respectively).It was positive with Caspase-3 when yellow or brown signal appeared in the cytoplasm of liver cells by immunohistochemistry.However,at the day 75 post-infection,the mRNA level and expression level of Caspase-3 of the experimental group were dramatically similar to the control group.Furthermore,in the experimental group,the mRNA level and expression level of Caspase-3 were significantly increased at day 75 post-infection than day 15 post-infection (P--0.018,P=0.003 and P=0.002 respectively).These results suggested that Caspase-3 might be involved into the regulation of the damage of porcine liver induced by T.asiatica challenge at the early infection stage and have on effect to the hepatic injury because of the dramatic recovery of Caspase-3 at the consequent infection stage.

Objective To clarify the serological characteristics and predictive value of HIV antibody indeterminant and to evaluate the efficiency of 3 assays to discriminate HIV antibody indeterminant.Methods Three hundred and ninety-four HIV antibody indeterminant serum samples were collected and the Western blot pattern were analyzed.Ninety-seven HIV antibody indeterminant individuals were followed up,and the development of HIV antibody were observed.The initial serum samples of 67 followed individuals were tested by viral load,line immunoblot assay and ELISA for HIV-1 p24,with the golden standard of follow up,the efficiency of 3 kinds of assay to discriminate HIV antibody indeterminant were evaluated.Results There were 38 patterns among 394 HIV antibody indeterminant,the proportions of env,pol and gag indeterminant were 37.54%,4.04%and 58.37% respectively.Five HIV antibody indeterminant cases were converted to HIV antibody positive among 97 followed individuals,they were all env indeterminant and HIV antibody developed rapidly.HIV viral load was an ideal assay to discriminate HIV antibody indeterminant with best sensitivity.Conclusion The indeterminant of gag were most common,but were unspecific reaction.Env indeterminant were with the greatest predictive value of HIV infection,especially the gp160p24 and gp160.Viral load assay can be applied to discriminate HIV antibody indeterminant.

OBJECTIVETo determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.

METHODSWe performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.

RESULTSUreterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.

CONCLUSIONAnatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.

Adult ; Cystoscopes ; Ejaculation ; physiology ; Ejaculatory Ducts ; anatomy & histology ; physiology ; Endoscopy ; instrumentation ; methods ; Hematuria ; Hemospermia ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostate ; anatomy & histology ; physiology ; Rectal Neoplasms ; surgery ; Semen ; secretion ; Spermatozoa

Actins ; metabolism ; Adult ; Amputation ; Arthroplasty, Replacement, Knee ; Bone Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Calmodulin-Binding Proteins ; metabolism ; Humans ; Leiomyosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Radiography ; Tibia ; diagnostic imaging ; surgery

ObjectiveTo investigate the effect of patient-controlled epidural analgesia(PCEA) with opioids on serous myelin basic protein(MBP) and somatosensory evoked potential(SEP) of lower limbs in puerperants.MethodsA total of 120 puerperants,after receiving cesarean section,were divided into four groups by random number table method as group B,BR,MR and R randomly,and each group included 30 cases.After surgery,each case received PCEA:group B received 0.008％ butrophanol;group BR received 0.008％ butrophanol + 0.2％ ropivacaine;group MR received 0.004％ morphine +0.2％ ropivacaine and group R received 0.2％ ropivacaine only.VAS score,OAA/S score,adverse effect occurrence,concentration changes of serous MBP,SEP of both lower limbs and neurological function were observed at 2h(T1 ),4h(T2),8 h(T3),12h(T4),24 h(T5) and 48h (T6) after surgery.ResultsVASscoresofgroupBR(1.64±0.38,1.86±0.62,1.93±0.67) and MR( 1.74 ±0.39,1.91±0.58,1.98 ±0.63) at T3,T4,T5 were lower than those of group B(4.6 ±0.5,4.6 ±0.3,4.7 ±0.3)and R(2.64 ±0.41,2.83 ±0.91,3.37 ±0.87) (P＜0.05).There was no significance in four groups in OAA/S score at each point (P ＞ 0.05 ).Incidence of nausea ( 6 cases),vomiting ( 2 cases) and abdominal distention ( 5cases) of group M was higher than that of other three groups(P＜0.05).There was no significant difference in concentrations of serous MBP,SEP and neurological function in all four groups between preoperative time and 48h after operation(P＞0.05).ConclusionLower-dose and lower- concentration opioids used for PCEA have no influence on serum MBP and SEP.