Objective To analyze the biochemical effect of cryosugery on residual bronchial tissue and the adjacent organs in dogs. Methods Bronchial stumps of 18 dogs after lobectomy and the adjacent tissues and organs(including 4 samples of esophagi, 3 diaphragms, 3 stomachs, 2 livers, 7 tracheae and 3 superior saphenous vein sinuses) of 22 dogs after thoracectomy were frozen. The observation from 1～212 d was conducted after surgery. Results Cryonecrosis and fibrosis were found in all 18 samples of the frozen bronchial stumps, but no fistula of bronchial stump was found. Three cryodamaged esophagi in 4 dogs developed fine sheet of fibrous membrane like scars in the situs of cryosurgery. Perforation was found in 2 dogs, one in the esophagus, another in stomach. No perforation was found in dogs with diaphragm cryosurgery. Cartilaginous ring disappeared in 7 dogs by cryosurgery of the trachea and a membrane like scar developed in the inner wall of trachea. There were yellow scars on the liver after cryosurgery. Conclusion Exfoliation of the necrotic tissues is slow due to the slowly developed cryonecrosis and good tolerance to cryosurgery of the fibrotic tissues. The original construction disappears but fibrosis develops. At the edge of cryo necrotic area, proliferation of capillary can be found.

Objective To investigate the feasibility and superiority of enteral-intestinal nutrition after opera- tion of replacement of esophagus with stomach.Methods 62 elderly patients with cancer of esophageal were radom- ly divided into early enteral-intestinal nutrition(EEN) group and total parenteral nutrition(TPN) group,the average cost of hospitalization,recovery situation,postoperative bodyweight,liver function,nutritional status were compared between the two groups.Results The average cost in the early enteral-intestinal nutrition group was less than that in the parenteral nutrition group,the bodyweight in two group were declined and the level of lactate dehydrogenase (LDH) were increased after operation,the level of transferring ferroprotein was lower in TPN group after operation than that in the EEN group(P

Objective To study the status of coincidence of high-risk human papillomavirus(HR-HPV)test and thinprep cytolo-gy test with biopsy histopathologic diagnosis.And to investigate the value of combined detection in the diagnosis of the cervical cancer and precancerous lesions.Methods High-risk HPV test and thinprep cytology test were taken simultaneously in 1374 pa-tients visiting department of gynecological oncology.The diagnostic value of combination assay of these indices was evaluated.Re-sults In 684 patients with ASCUS pathology diagnosis,inflammation accounted for 5 1.3% and CINⅠ accounted for 47.4%.A-mong the 375 patients with LSIL pathology diagnosis,CINⅠ accounted for 48.5% and CIN Ⅱ-Ⅲ accounted for 21.3%.Among the 294 patients with HSIL pathological diagnosis,CIN accounted for 24.5%,and CIN Ⅱ-Ⅲ accounted for 62.9%.Among 20 pa-tients with SCC pathology diagnosis,CIN Ⅱ - Ⅲ accounted for 20% and cervical cancer accounted for 80%.Statistical analysis showed the difference of diagnostic results between thinprep cytology test and histopathologic diagnosis was statistically significant (P <0.05).The positive rate of high-risk HPV was 74.3%,and the negative rate was 25.7%.The positive rate of high-risk HPV significantly increased along with the rise of pathological level.The difference of pathologic diagnosis results between high-risk HPV positive group and negative group was statistically significant (P <0.05).When thinprep cytology test combined with high-risk HPV test,its sensitivity was 76.5%,and the specificity was 80.3%.The difference of the sensitivity between joint detection and thinprep cytology test was statistically significant (P <0.05).The difference of the specificity between joint detection and high-risk HPV test was statistically significant (P <0.05).Conclusion Combined thinprep cytology test and high-risk HPV test will improve the detection rate of cervical lesions and it is an ideal method to screen for cervical cancer.

Animals ; Disease Models, Animal ; Heart Failure

Objective To assess the accuracy of cerebral oxygenation measured by near-infrared spectroscopy (NIRS) in predicting ischemic cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Seventeen patients undergoing cardiac valve replacement under CPB were enrolled in this study. During operation, NIRS was used to measure regional oxygen saturation (rScO2),tissue hemoglobin index ( THI ), changes in concentrations of oxyhemoglobin (△ O2 Hb ), deoxyhemoglobin (△ HHb) and total hemoglobin (△ cHb) of the frontal lobes. The parameters mentioned above and patients whose minimal rScO2 decreased to less than 50% were recorded after entering the operation room, immediately after tracheal intubation, aortic cannulation and superior and inferior vena cava cannula, at the beginning of CPB, at the lowest temperature during CPB, after rewarming to 36.5 ℃, immediately after termination of CPB, and at 1 h after termination of CPB. Blood samples were taken from right internal jugular vein immediately before anesthesia induction, before rewarming, after rewarming to 36.5 C, and at 1, 5 and 20 h after termination of CPB to detect plasma concentrations of S100 protein and neuron-specific enolase (NSE) by ELISA. The cognitive function of patients was assessed 1 day before surgery and 8 days after surgery, and postoperative cognitive dysfunction (POCD) was recorded. Results Nine patients presented with minimal rScO2 less than 50%. Among them,7 patients developed POCD. The plasma concentrations of S100 protein and NSE were significantly higher at 1 and 5 h after termination of CPB in patients whose minimal rScO2 decreased to ≤ 50% than in those whose rScO2 ＞50% .Conclusion Cerebral oxygenation measured by NIRS can accurately predict cerebral ischemic injury in patients undergoing cardiac valve replacement under CPB.

Objective To conduct targeted surveillance of nosocomial infections in intensive care units(ICU)to provide reference for comprehensive infection control . Methods All the 374 patients treated in ICU in 2013 were investigated by targeted surveillance methods .Results A total of 82 episodes of nosocomial infections were identified in 62 (16 .6% )of the 374 patients . The cumulative hospital stay was 2 724 days .The infection incidence per patient‐day was 22 .8‰ .The infection in ICU was primarily pneumonia (75 .6% ,including 39 ventilator‐associated pneumonia) ,bloodstream infections (including 6 central line‐associated bloodstream infections ) and catheter‐associated urinary tract infections . The incidence of ventilator‐associated pneumonia ,central line‐associated bloodstream infection and catheter‐associated urinary tract infection was 33 .3‰ ,2 .8‰ , 2 .3‰ patient‐day ,respectively .Overall ,74 strains of pathogens were isolated ,of which 93 .2% ,5 .4% and 1 .4% were gram‐negative bacilli ,gram‐positive cocci and fungi ,respectively .The top three gram‐negative bacilli were Pseudomonas aeruginosa(25 .7% ),Klebsiellapneumoniae(14 .9% ),and Acinetobacterbaumannii(10 .8% ).Conclusions Theincidenceof nosocomial infection was 16 .6 % in ICU patients ,of which device‐related infection accounted for 62 .2 % .Control of equipment‐related infections is critical for curbing the nosocomial infections in ICU . The antimicrobial regimens for ICU patients should cover gram‐negative bacilli .

Every stage of tumor initiation and development closely relates to immune regulation as tumor cells tend to evade attacks from immune system by employing the programmed death 1 (PD-1)/ programmed death-ligand 1 (PD-L1) interaction.Therefore,targeting the PD-1/PD-L1 pathway has become an attractive approach for cancer immunotherapy.Radiotherapy has long been considered a local tumor treatment modality and it is immune-inhibitory.However,accumulated evidence has shown that radiotherapy might enhance immune function by eliminating the tumor mass and has become a systemic tumor treatment modality.These observations indicate a strong rationale that the radiotherapy and anti-PD1 and anti-PD-L1 immunotherapy may work synergistically to provide a powerful anti-tumor effect.This review discusses current progresses,challenges and perspectives of this novel combination treatment modality.

Objective To evaluate and analyze the effects between with modified Forsus appliance and activator in the treatment of class Ⅱ madibular retrusion.Methods 70 children with class Ⅱ malocclusion and mandibular retrusion were selected and divided into two groups:35 patients treated with this modified Forsus appliance (group A) and other 35 treated with activator (group B).Cephalometric radiographs were taken and analyzed at the pre-treatment time (T0) and the post-treatment time (T1) with the Pancherz analysis.Results The course of treatment was obviously different:the course of group A was (21.4±2.0) months,and group B was (27.3±2.5) months; the treatment course of group A was shorter than that of group B.After treatment,profiles of the two groups were obviously improved.The trends were similar in overjet and the molar relationship,SNB and ANB,with significant differences.But there was no significant difference between the results of the two groups.The change of occlusal plane was notably in group B.Conclusions Both the modified Forsus appliance and activator appliance combined with straight wire appliance can effectively stimulate the mandibular growth,balance the jaw relationship,and correct the class Ⅱ mandibular retrusion.But the modified Forsus appliance can effectively treat the class Ⅱ patients with the shorter course.And the same time,it can take effect continually without depending on the coordination of the patients.

Objective To investigate the role of retroperitoneal lymph node dissection (RPLND) in the treatment of testicular cancer. Methods The clinical data of 39 cases (age range,20-58 years;median age,29 years) of germ cell tumor who underwent RPLND were retrospectively analyzed.Of the 39 cases,17 had the tumors on the left side and 22,on the right.One case was of seminoma,and the other 38 were of non-seminomatous germ cell tumor (NSGCT).According to the clinical examinations and radiology, 20 cases were of stage Ⅰ,15 of stage Ⅱ,and the rest 4 could not be staged. Results Of the 39 cases,10 with stage I tumors underwent nerve-sparing modified RPLND and the other 29 underwent bilateral RPLND.No metastasis was found in the dissected tissues in 22 cases,while metastasis,in 17 (including 4 of clinical stage I).All the patients with pathological metastases or elevation of blood tumor markers received postoperative chemotherapy.Follow-up was carried out for 1-149 months.The disease-free survival rate was 97.4%(38/39).Of the 10 cases receiving modified RPLND,8 regained their ejaculation function. Conclusions The probability of presence of the non-seminomatous components must be considered in the diagnosis and follow-up of seminoma cases,and the RPLND should be done if necessary.Nerve-sparing modified RPLND should be performed for clinical stage Ⅰ patients;while postoperative chemotherapy should be chosen for pathological stage Ⅱ patients.

Objective A retrospective study was conducted to evaluate the clinical significance of Video EEG monitoring in the diagnosis of epilepsy and other paroxysmal events Methods Video EEG monitoring under the state of awaking and sleeping and evoked tests were performed continuously in 216 patients with epilepsy and other paroxysmal events Results The characteristic events were captured in 130(60%) of the 216 patients And out of the 130 patients, 53 had clinical events accompanying epileptiform discharge 73 patients had no epileptiform discharge in both ictal and interictal period Seizure types were defined in 80%of 80 patients with epileptiform discharge, and classification was different from the original 42% of the 64 patients Conclusions Video EEG can record much more epileptiform discharge than routine EEG It should be an effective method in both diagnosis and classification of epilepsy