Objective To observe the value of adenosine deaminase(ADA)in differential diagnosis of hydrothorax.Methods In this study,93 subjects were collected in the second Xiangya hospital from Oct 2007 to Mar 2008.The patients were divided into three groups.which were the malignant hydrothorax group,the tuberculous hydrothorax group and the transudative hydrothorax group.We measured the adenosine deaminase(ADA)in pleural effusion of every patients with continuous monitored enzymatic method.Results The values of ADA in the three group were(14.24±12.90)U/L,(49.36±15.75)U/L and(10.12±7.87)U/L,respectively.There were significant differences for the values of adenosine deaminase(ADA)among the three groups,For instance,The value of adenosine deaminase(ADA)in the tuberculous hydrothorax group was greatly different with that of the transudative hydrothorax group(P＜0.01).Conclusion Detection of adenosine deaminase(ADA)has highly differential diagnosis value and can be as supplementary method to diagnose tuberculous hydrothorax.

A literature review was written to introduce the choice of therapy for primary liver cancer (PLC).It was concluded that hepatic resection, liver transplantation, cryotherapy, microwave coagulation treatment, radiofrequency ablation, transarterial embolization or transarterious chemoembolization, percutaneous ethanol injection, radiotherapy and biotherapy could increase the survival rate, and surgical resection combined with other therapeutic methods is the main treatment for primary liver cancer.

Objective To evaluate clinical features and the clinical application of radical transabdominal operation for the senile cardiac cancer by using the EEA(end-to-end anastomosis) stapler.Methods 80 senile patients underwent curative intent due to cardic cancer from 1991 to 2001,and the clinical effects of transabdominal operation for cardiac carcinoma by using the EEA stapler were investigated retrospectively.Results The average age of the patients was 70-year old, and the ratio of men to women was 5∶1. The average course of the disease was 3 2 months. Only 2 5% of the patients got early diagnosis, and the rate of the preoperative complications was 60%. Patients were treated by radical transabdominal operation by using stapler, and the rates of radical dissection and palliative dissection were 71 3% and 18 8% respectively. The incidence of postoperative complication was 5%, and the in-patient mortality was 1 25%, and the above indexes were significantly lower than those in the trans-thoracicoabdominal approach. The 5-year survival rate was 20% after gastrectomy.Conclusions This study showed that the approach exerted little effect on the respiratory and circulatory systems, and it could decrease the surgical risk and the incidence of diverse complications.

Objective To investigate the risk factors of death in patients with severe acute pancreatitis within 24 hours after admission. Methods Sixty patients with severe acute pancreatitis admitted from Jan. 2000 to Dec. 2003 were divided into two groups , death group 21 cases and survival group 39 cases. Clinical and laboratory data within 24 hours after admission of those patients were analyzed retrospectively, and Logistic regression analysis was performed. Results The average age in death group was (66.6?16.1)years,breath rate in admission (29?9)/min, urine volume within 24 hours(1062?815) ml,serum creatinine(190.6?120.1) ?mol/L, arterial pressure of O2 (58.5?17.3) mm Hg, APACHE Ⅱ score 19.3?7.5;while correspondent data in survival group were (52.4?13.1) years,(20?2)/min, (1648?575) ml, (94.4?56.0) ?mol/L,(78.8?18.0) mm Hg and 9.1?2.0,respectively. Significant differences were existed between two groups(P

Objectives Esophageal cancer development and progression is driven by the accumulation of genetic changes. In this study, we used tissue microarray to survey the expression of p53, p16 and COX-2 in esophageal cancer progression and their clinical implication. Methods We tested p53, p16 and COX-2 proteins by immunohistochemistry and tissue microarray in 86 specimens from different stages of esophageal cancer and 40 specimens from adjacent non-cancer tissue. Results The expression of p53 and COX-2 was significantly higher in tumor tissue than that in non-tumor ones. As for the expression of pl6, no significant difference was found between tumor and adjacent tissue. An obvious relation was observed among p53, p16 and COX-2 expression that esophageal carcinogenesis was highly correlated with the positive expression of p53 or COX-2, however, no reciprocal relationship to neoplastic progression was recognized with p53, p16 and COX-2. Conclusion We observed that the tissue with the positive expression of p53 or COX-2 was more likely to develop esophageal cancer. Further work will verify the hypothesis that the expression level of p53 and COX-2 in biopsy specimen is applicable to predict early outset of esophageal cancer.

Objective To assess the effect of chloramine disinfection on the formation of drinking water disinfection by-products(DBPs )and their mutagenicity.Methods The bacterial indices,chloroform and carbon tetrachloride content in the finished water samples using liquid chlorine and chloramine disinfection respectively were determined in August,2001(plentiful water season)and in March,2002(low water season).The mutagenicities of organic extracts from the water samples were tested using Ames test.The levels of DBPs and the mutagenic activities of water samples treated with different disinfection methods were compared.Results The total count of bateria and coliform bacteria were0/ml and0/L respectively at free chlorine con-centration of about 1mg /L in the chloraminated drinking water,which decreased81%-84%compared with those of the chlori-nated drinking water samples.The carbon tetrachloride concetration were all

Objective To study the clinicopathologic classification,and methods of individualized treatment of Budd-Chiari syndrome (B-CS).Methods Analysed the clinical data of 42 cases of B-CS in our hospital from March 2006 to August 2010.Results The 42 patients were divided into three types,including 5 subtypes,which of them underwent operation or the interventional therapy,All kinds of bypass,a total of 20 cases.After operation,1 case appeared hepatic encephalopathy and die from it,the others all recovered well.Radical lesion resection and thrombosis was taken out in 7 cases; a balloon catheter in 5 cases and postoperative recovered well.The spleen-lung fixation in 6 cases were cured after operation.The three cavity two capsule tube was used oppression hemostasis for 4 patients with emergency bleeding,three cases was cured of joint spleen cut + cutoff,1 case with conservative treatment is invalid,died.The 41 cases received follow-up,during the follow up period of 3 months to 3 years,2 patients had recurrence (4.9％),and the other patients recovered satisfactorily.Conclutions According to different the clinicopathologic classification of B-CS,Taking individualized treatment may further improve the clinical curative effect.

Objective To explore the treatment effect and application value of proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fractures.Methods 86 patients with proximal humeral fractures were selected,using the random number table method they were randomly divided into the observation group and control group,each group had 43 cases.The control group was treated with locking plate method,and the observation group was treated by the combination of artificial bone and locking plate.The therapeutic effect of the two groups was observed.Results The excellent and good rate of the observation group was 93.03％,that of the control group was 74.42％,the difference was statistically significant between the two groups(x2 =5.460 3,P ＜0.05).In observation group,the fracture healing time was (11.78 ± 3.64) weeks,the shoulder joint function score was (96.87 ± 4.23) ; those of the control group were (19.65 ± 6.27) weeks,(78.73 ± 8.28),the differences were statistically significant between the two groups (t =7.118 2,12.793 4,all P ＜ 0.05).The incidence rate of complications of the observation group was 6.98％,which was significantly lower than 30.23％ of the control group (x2 =7.678 6,P ＜ 0.05).Conclusion Proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fracture has reliable curative effect,short fracture healing time and mild surgical complications,which is worth popularizing in clinical.

Objective:To solve the ultimate problem of research on tongue's texture,that is the real appearance and development rules of tongue's texture on healthy person.This article is proposed to provide the references on feature recognition of creature and judgments on cases of tongue's texture.Methods:After taking the continuous,systematic and different ages samples of tongue's texture by three medical instruments and the multidirectional double smoothing dimension extraction algorithm of area of tongue's texture,the binary images of tongue's texture are extracted and stored in computer database of tongue's texture to analyze comprehensively and systematically.Results:Among the 5 535 healthy person,it can be divided into two groups,the number of one group which couldn't diagnose tongue's texture exactly with naked eyes(without any amplification)is about 1 074 accounted for 19.40%and the number of another group which could diagnose tongue's texture clearly with naked eyes and computers is about 4 464 accounted for 80.60%.There are 18 sorts according to the appearances of tongue's texture in which the number of straight tongue's texture is about 69.00%,the horizontal tongue's texture is about 18.54%, the oblique tongue's texture is about 11.48%and the other tongue's texture is about 0.99%.Conclusions:The tongue's texture of healthy person show appearances of regularity,straight,horizontal and oblique texture.From the development rules of tongue's texture on 30 continuous observing healthy person and among the 1 233 cases,these conclusions could be made that any kind of slightly imbalance of yin and yang or obstruction of entropy flow will lead to the changes of color,diaphragm,material being of tongue's texture.It will also change according to the patient's condition.

Objective To study the diagnosis and treatment of primary liver cancer(PLC) with bile duct cancer thrombus (BDT). Methods The clinical data of 21 patients with PLC and BDT admitted in the past 8 years were analyzed retrospectively . Results The major clinical manifestations were the symptoms of primary liver cancer and obstructive jaundice. The correct diagnosis rate was 76.2% before operation. The diagnosis rate of B-us, CT, MRI, ERCP and PTC was 14.3%, 9.52%, 14.3%, 71.4% and 100% respectively. The operative procedures included hepatectomy with removal of BDT ( n =10), hepatectomy combined with extrahepatic bile duct resection ( n =5), thrombectomy through choledochotomy with TACE ( n =3), removal of BDT with HAI ( n =3). The 3,5-year survival rate were 43.20% and 24.60% respectively. Conclusions Multi-examinations should be applied in the diagnosis of PLC with BDT. The comprehensive therapy including surgery and other therapies must be adoptted for PLC with BDT.