Objective To evaluate the efficacy and safety of combined intrapleural therapy with bevacizumab and cisplatin in controlling malignant pleural effusion(MPE)caused by non?small cell lung cancer(NSCLC). Methods A total of 63 NSCLC study subjects with MPE were randomly assigned to one of two groups(A and B). Group A(bevacizumab,n=32)received intrapleural bevacizumab(5 mg/kg)with cisplatin(40 mg/m2) therapy once a week for a total of three cycles. Group B(cisplatin,n=31)received intrapleural cisplatin therapy alone with the same dose and cycle. Pleural fluid was collected from both groups prior to and after treatment. The levels of VEGF in the pleural fluid were determined by ELISA. The cura?tive effect and adverse reaction were observed and follow?up was conducted. Results In 63 evaluable study subjects,the curative efficacy in the be?vacizumab group was significantly higher than that found in the cisplatin group(84.3%vs 61.3%,respectively,P<0.05). But the overall survival (OS)of the two groups showed no statistically significant difference(13.0 months vs 12.0 months,P>0.05). After treatment,The VEGF levels in the MPE were significantly decreased in both groups. In the bevacizumab group,the levels of VEGF in the pleural fluid were significantly lower com?pared to those of the cisplatin group after treatment,showing greater efficacy(P<0.05). The VEGF levels of the two groups whose treatment was in?valid had no statistically significant difference(P=0.079). There was no significant difference in gradeⅢ/Ⅳadverse events between the two groups. All procedures were well tolerated by the patients. Conclusion Combined intrapleural therapy with bevacizumab and cisplatin was effective and safe in managing NSCLC?mediated MPE. The patients showed high tolerance to the therapy. For prediction of local treatment efficacy of bevaci?zumab using the VEGF expression levels in MPE,further research was needed.

100% elevation of PKC activity in the retina, and administration of D ? tocopherol prevented the elevation of PKC activity and diabetes induced decrease of both Na + K + ATPase and Ca 2+ ATPase activities. D ? tocopherol achieved a complete prevention of augmented pericyte and endothelial cell profile areas and basement membrane thickening in the superficial and deep capillaries bed of diabetic retina but had no effect on blood glucose and HbA 1c . Conclusion Diabetes induced histopathological abnormalities are mostly mediated by PKC. D ? tocopherol reduces the ultrastructural lesions in retinal capillary bed induced by hyperglycemia.

Adult ; Female ; Humans ; Immunohistochemistry ; methods ; Male ; Meningeal Neoplasms ; immunology ; ultrastructure ; Meningioma ; immunology ; ultrastructure ; Microscopy, Electron ; Middle Aged ; Paraganglioma ; physiopathology

Objective To investigate the clinical application value of the critical value electric reporting system .Methods The critical value data from Aug .1 ,2015 to Jan .31 ,2016 were inquired through the electronic hospital information system (eHIS) .The incidence rate of critical values ,items distribution and department distribution were analyzed .Results A total of 3 405 items of crit‐ical value were reported .The occurrence rate of critical values was 0 .45% .The top 5 of critical values numbers were chlorine (25 .76% ) ,myocardial‐specific isoenzyme of creatine kinase (19 .97% ) ,serum sodium (9 .43% ) ,platelet count (9 .05% ) and partial pressure of carbon dioxide (6 .40% ) .The top 5 departments of critical values reported number were the cardiology department (18 .94% ) ,followed by neurological intensive care unit (12 .04% ) ,intensive care unit (9 .52% ) ,second wards of neurosurgery (5 .11% ) and neurovascular wards (5 .02% ) .The median time of critical value report was reduced by 33 .33% and the quartile range time weas reduced by 40 .00% .Conclusion The application of critical value electric reporting system reduces the elapsed time of critical value report ,increases the promptness and accuracy of critical value report ,and has an important significance to guarantee the medical quality .

Objective To analyze the characteristics of benign paroxysmal positional vertigo (BPPV) and the efficacy and safety of Epley's maneuver in very old patients.Methods A retrospective review of 29 ( 16.5% ) patients with BPPV out of 176 consecutively admitted patients aged 80 and over presented with a complaint of dizziness was performed.Results In all 29 patients the BPPV origin was attributed to posterior canal involvement;24 (82.8% ) disease, and 1 secondary to head trauma;18 (62.1%) were right-side involved;and 25(86.2%) were diagnosed previously as vertebral-basilar insufficiency.Cardio- and cerebrovascular diseases and the correlative risk factors were common both in patients with BPPV and those with non-BPPV dizziness.Twentyone patients underwent Epley's maneuver, all were free of vertigo after treatment, 14 of them after a single session and the remaining 2 to 4 sessions.No significant complications were observed except in one who experienced vomiting during the procedure.Patients who received Epley's maneuver had a higher cure rate and short recovery time than those who did not.Conclusions BPPV is not uncommon in very old patients with dizziness.Clinicians should have the knowledge to diagnose and treat this condition.Epley's maneuver is safe and effective in very old patients with BPPV.

Objective To analyze the onset time rule of spontaneous pneumothorax ,and investigate the influence of climatic factors such as atmo-spheric pressure,wind speed,etc. on the onset of spontaneous pneumothorax. Methods Five hundred and ninety-three patients of spontaneous pneumothorax in Cenral Hospital Affiliated to Shenyang Medical College were enrolled for this study between January 1,2011 and December 31, 2015. The data of the average daily atmosphere pressure and wind speed in five years were recorded. The relationship between the onset of sponta-neous pneumothorax and the change of the atmosphere pressure and wind speed was analyzed. Results The incidence of spontaneous pneumotho-rax in Shenyang area was obvious seasonal. Primary spontaneous pneumothorax episodes were observed mostly in spring and in March and April;Second spontaneous pneumothorax episodes were observed mostly in winter and in November and December. The difference in mean atmospheric pressure was 0.6 hPa lower than on days in which no spontaneous pneumothorax occurred. This difference was statistically significant(P=0.015). We observed significantly higher average wind speed on days with SP versus days without(9.46±6.33 m/s vs 7.11±5.47 m/s,P<0.001). Conclu-sion Spontaneous pneumothorax has obvious aggregation of onset time. A sharp drop in atmospheric pressure and increases in wind speed has im-portant influence on the incidence of spontaneous pneumothorax.

Objective To quantitatively investigate the effect of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleus-containing cells of radiation workers.Methods Nine electronic databases were systematically searched on the basis of the published studies evaluating the effects of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleuscontaining cells.Of the 195 studies searched,21 studies were identified with a total of 1 970 626 cells under studying.Cochrane' s Q and I2 statistics were used to evaluate heterogeneity among studies and pooling odds ratio (OR) with 95％ confidence intervals (CI) were calculated using random-effect models or fixed-effect models,and publication bias were also calculated.Meta-analysis was performed using Stata 12.0.Results The pooling OR of chromosome-type aberrations [OR =3.03 (2.59,3.56)],dicentric plus centric rings [OR =4.12 (2.99,5.67)],translocations [OR =2.73 (1.67,4.46)],micronucleuscontaining cells [OR =1.70 (1.40-2.06)] were higher for radiation workers when compared with control group.Conclusions The frequencies of chromosome aberrations and micronucleus cell of peripheral lymphocytes are significantly high in radiation workers who were occupationally exposed to low-dose ionizing radiation.It should be noted that the radiation protection of radiological workers be enhanced.

Objective To investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.

Objective To comprehensively analyze the effect of low-dose radiation on the lens of the eye of radiation workers.Methods The papers dealing with the relationship between occupational radiation exposure and the lens of the eye were collected by retrieving documents of the domestic and foreign medical information databases with references to other papers.There were 28 papers finalized with 17 608 workers included in the Meta-analysis.Stata12.0 was used for Meta-analysis,Q-test and I2 statistic for heterogeneity test,and funnel regression method,Begg's rank method and Egger's regression method for publication bias.Results The pooling odds ratio (OR) opacity in radiation workers were 2.51 (2.01,3.13),4.03 (2.77,5.85),respectively.Conclusions Low-dose radiation may lead to negative impact on ocular lens under the current occupational protection conditions.The proportion of posterior subcapsular opacity in radiation-related cataract is higher than that in age-related cataract.It is important to strengthen radiation protection of ocular lens.

BACKGROUND:Subcutaneous effusion often occurs after digital shaping titanium mesh cranioplasty, and affects therapeutic effects.
OBJECTIVE:To explore the causes and corresponding prevention measures of subcutaneous effusion after digital shaping titanium mesh cranioplasty.
METHODS: We retrospectively analyzed the clinical data and treatment methods of 19 cases of subcutaneous effusion after digital shaping titanium mesh cranioplasty, summarized the postoperative complications and explored the effective methods for prevention and treatment of subcutaneous effusion.
RESULTS AND CONCLUSION: After active treatment, five cases of dural breakage, four cases of foreign body stimulation, three cases of getting out of bed early, three cases of early extubation, three cases of long-time operation repair, and one case of excessive use of electric knife were al cured. Dural breakage and foreign body stimulation is considered as the main causes of postoperative effusion. Patients with subcutaneous effusion were given releasing elastic bandage, aspiration, and strict bed rest. After these active treatments, patients were al cured. Subcutaneous effusion may result from single or mixed factors. The above-mentioned causes are only a part. Non-central suspension, incomplete hemostasis, and preoperative excessive colapse of the bone window are al reported to be the reasons for the occurrence of subcutaneous effusion.