Objective To compare the accuracy of quantitative CT(QCT), perfusion scintigraphy and anatomical segmentation in predicting postoperative lung function in lung cancer patients. Methods Pulmonary functional tests, quantitative CT scan and perfusion seintigraphy in 12 cases before operation were performed. Forced vital capacity (FVC), the first second forced expiratory volume (FEV1.0) and diffusing capacity of carbon monoxide (DLco) were obtained from preoperative pulmonary functional tests. According to the corresponding formula for QCT, perfusion sintigraphy and anatomical segmentation method, the values of FVC, FEV1.0 and DLco were predicted. The correlation between the predicted values and postoperative values of FVC, FEV1.0 and DLco were assessed. The paired-t test,Pearson correlation test and Bland-Altman analysis were used for the statistics. Results The predicted values of QCT, perfusion sintigraphy and anatomical segmentation method were: FVC [(3.05±0.82), (2.98±0.75) and (2.98±0.86) L,respectively] , FEV1.0[(2.20±0.81), (2.17±0.78) and (2.16±0.84) L, respectively], DLco (FVC: r=0.87, 0.80 and 0.86; FEV1.0:r =0.93, 0.91 and 0.93; DLco:r =0.93, 0.95 and 0.93,respectively,P < 0.01). Conclusion QCT, perfusion sintigraphy and anatomical segmentation method can be used in predicting postoperative lung function. The predicted values are in concordance with the postoperative ones.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Diagnosis, Differential ; Female ; Humans ; Panniculitis ; drug therapy ; pathology ; Panniculitis, Nodular Nonsuppurative ; pathology ; Prednisone ; administration & dosage ; Vincristine ; administration & dosage

To analyze one case of multi-organ involvement of immunoglobulin G4-related disease and to review the related literatures.Through investigating the clinical data of one case of multi-organ involvement of immunoglobulin G4 (IgG4)-related disease,many related references were retrospected.IgG4-related disease and multi-organ involvement are used as the key words to search on Pubmed and Wanfang Database.According to the clinical manifestations,including serology,imaging,histopathology,responses to steroid therapy,a 65-year-old female patient was diagnosed as IgG4-related disease.The patient exhibited salivary gland swelling,lacrimal glands,and orbital soft tissues.And multiple organs such as pancreas,liver,bile duct,retroperitoneum,the lymph node,lung,paranasal sinuses,kidney and ureter were affected in the patient.Glucocorticoids are the mainstay of therapy and the recommended dose is 0.5-1.0 mg · kg-1 · d-1.Immunosuppressive agents need to be used in relapsing patients or in the patients with multi-organ involvement and serious complications.IgG4-related disease usually affects many systems and involves multiple organs,which is always misdiagnosed to other diseases.Both the correct diagnosis with multidisciplinary fields and the early treatment with glucocorticoids are very important.

Objective To investigate the influence of hydroxyethyl starch solution on exogenous coagulation and active protein C (APC) in the patients with septic shock.Methods A single-center prospective study was conducted.Eighty-four consecutive patients with septic shock admitted to intensive care unit (ICU) of Peking University People's Hospital from November 2009 to October 2014 were enrolled.The patients were randomized into two study groups by random digits table:Ringer lactate solution group (RL group,n =40) and hydroxyethyl starch group (HES group,n =44),and Ringer lactate solution or hydroxyethl starch 130/0.4 was used for resuscitation respectively.Peripheral blood was collected at four time points:before resuscitation,6,12,and 24 hours after resuscitation.The prothrombin time (PT),tissue factor (TF),tissue factor pathway inhibitor (TFPI) and APC were determined,and the length of ICU stay and the mortality were recorded.Results There were no significant differences in PT,TF,TFPI,and APC before and after resuscitation in RL group.No change in PT was found after resuscitation in HES group,and no significant difference was found as compared with RL group.TF after resuscitation in HES group was decreased gradually,and the level at the 24 hours after resuscitation was significantly lower than that before resuscitation (U/L:15.80±7.32 vs.31.40±2.75,P ＜ 0.05); but there was no significant difference at all time points when compared with that of RL group (all P ＞ 0.05).TFPI at 12 hours and 24 hours after resuscitation in HES group was increased when compared with before resuscitation (μg/L:1.32±0.22,1.14±0.09 vs.0.63±0.54).TFPI in HES group was significantly higher than that in RL group (μg/L:0.84 ± 0.69,0.95 ± 0.30),but there was no significant differences between two groups (both P ＞ 0.05).APC after resuscitation in HES group was decreased gradually,which was significantly lower than that in RL group at 6,12,24 hours after resuscitation (mg/L:3.38±3.00 vs.5.98±4.12,3.31 ± 1.94 vs.5.33 ± 3.71,3.42 ± 2.64 vs.7.53 ± 4.67,P ＜ 0.05 or P ＜ 0.01).The length of ICU stay in HES group was significantly shorter than that in RL group (days:12.50 ± 8.83 vs.17.10± 16.60,t =9.037,P ＜ 0.001),but there was no significant difference in mortality between HES group and RL group [40.9％ (18/44) vs.60.0％ (24/40),x 2=2.339,P =0.126].Conclusions Both RL and hydroxyethyl starch fluid resuscitation did not affect the PT of the patients.The use of hydroxyethyl starch probably inhibits excessive activation of the exogenous coagulation and hyper-coagulation in the early stage of sepsis,and inhibits activation of protein C as well.

Abstract?Since the introduction of 25-gauge/23-gauge ( 25G/23G ) sutureless micro -incision vitrectomy surgery ( MIVS ) at the beginning of the 21 century, we have stepped into an era of micro-incision vitreoretinal surgery more than10a. The current 25/23G MIVS provide numerous advantages over the conventional 20G vitrectomy surgery including simplified surgical procedure, shortened operating time, decreased complications as well as smaller sclerotomy wound.As a result, vitreoretinal surgeons have been shifting gradually from 20-gauge to 25/23-gauge vitrectomy in the past decade. As the 25/23G MIVS adapted worldwide, however, its drawbacks were also increasingly reported. Most criticism regarding to current 25/23G MIVS are focusing on would sealing related complications.Based on stablished notion regarding vitrectomy -“the smaller the better”, researchers and doctors were keeping on exploring the next generation of vitrectomy system. Thanks to the innovation and development in new generation vitrectomy machines, high lumen output light source, more delicate manufacturing technology and clear wild angle fundus view system, Dr.Oshima from Japan launched the first 27-gauge vitrectomy surgery system.It provided us novel surgical experience with smaller sclerotomy wound and faster cut rate. Further development and refinement of vitrectomy with 27-gauge or more are still on its way and will continue in the future. Undoubtedly, MIVS would be heated debated regarding its pro/con, complications, indications and future development.Combined with our own experiences, here we briefly reviewed the 27-gauge vitrectomy surgery.

Objective To evaluate the quality of life (QOL)among patients with anti -TB treatment in Zhoushan city and to analyze the influence factors.Methods Our self -designed questionnaire and WHOQOL -BREF scale were used to investigate the general information and the quality of life among 187 tuberculosis patients.Scores of life quality under different conditions were compared.Results The scores of physiological domain,psychological domain,social relations and environmental domains were 61.13 ±13.12,53.24 ±16.59,59.91 ± 12.08 and 60.12 ± 15.68 respectively. The scores of all domains excluding the environmental relations were significantly lower than the normal level (P <0.05). The scores of males were significantly higher than females in psychological domain (P <0.05),and the score differences among age groups were of statistical significance both in physiological domain and psychological domain (both P <0.05). Those with high education levels scored higher than those with lower education level in psychological and social domains (both P <0.05).The scores of different economic income in 4 domains showed significant differences (all P <0.05). The first time treated,hospitalization time less than 1 month and effectively treated patients scored higher than those not (all P <0.05).Conclusion The quality of life among tuberculosis patients could be influenced by sex,age,income, education,and treatment factors,so appropriate health care such as psychological support and health education should be provided.

Objective To explore the association between DNA methyltrsansferase 3a (DNMT3a) expression and interleukin-4 (IL-4),interferon-gamma (IFN-γ) in mononuclear cells of colonic laminapropriamucosae in ulcerative colitis (UC) patients.Methods From November 2009 to March 2010,sixty colonic mucosa biopsy specimens through colon scopy were collected,specimens of active UC or normal controls were 30 in each group.The expression of DNMT3a,IL-4,and IFN-γ was detected with immunohistochemical method (SABC) in mononuclear cells of colonic laminapropriamucosae,and their relation with different degrees of colonic inflammatory response was analyzed.Results The positive expression rate of DNMT3a,IL-4,IFN-γ in mononuclear cells of colonic laminapropriamucosae in active UC group was significant higher than that in control group and there were statistically significant differences (x2 =16.596,P=0.000;x2 =42.857,P=0.000;x2 =6.667,P=0.024;).The expression of them was higher in sever inflammatory response than that in mild inflammatory response,and its expression intensity increased as inflammatory activity became more severe.There was positive correlation between IL-4,IFN-γ and DNMT3 expression in UC group (r=0.46,P=0.01 ;r=0.559,P=0.001).Conclusions The expression of DNMT3a,IL-4 and IFN-γ is associated with the degree of colonic inflammatory response.DNA methylation maybe involved in Th1/Th2 immune balance regulation in UC pathogenesis.

Objective To explore the related risk factors of injuries caused by non-motor vehicle crashes in Hefei,Anhui Province. Methods From June 2009 to June 2011,the wounded from nonmotor vehicle crashes in Hefei were admitted to our hospital.The data of the wounded were collected to perform hypothesis test to screen out the related risk factors,which were then analyzed with multiple-factor non-conditional Logistic regression analysis. Results A total of 205 cases who were wounded in the non-motor vehicle crashes were admitted to our hospital from June 2009 to June 2011.Among all the cases,146 cases were wounded in electric bicycle crashes and 59 cases in bicycle crashes.There were 147cases (71.7％) of mild to moderate injuries ( ISS ≤ 15 ),and 58 cases (28.3％) of severe injuries (ISS ＞ 15 ) including six deaths (2.9％).Single factor of different categories of the hypothesis test suggested that age,category,driving behavior,crash model,impact type,vehicle type were all related with the severity of injuries caused by non-motor vehicle crashes in Hefei.The multiple-factor non-conditional Logistic regression analysis showed four risk factors for the injury severity in non-motor vehicle crashes in Hefei,ie,vehicle type,crash model,violations of rules and regulations as well as age,according to the degree of correlation.Conclusion With the study of non-motor vehicle crashes in Hefei,primary identification of the risk factors for the traffic injuries is obtained,which provides scientific basis for the decrease of casualty and establishment of intervention measures.

To investigate the relationship between plasma level of homocysteine(Hcy) and the methylenetetrahydrofolate reductase ( MTHFR ) gene polyroorphism with non-alcoholic fatty liver in patients with type 2 diabetes mellitus (T2DM). Methods In a case-control study, plasma levels of Hcy, folic acid (FA), vitamin B12 (VitB12), glycosylated hemoglobin Alc (HbAlc), fasting blood glucose (FBG), total cholesterol and triglyceride were measured in 159 T2DM patients with and without non-alcoholic fatty liver ( NAFL), as well as 52 normal controls. Mutation of the C677T of MTHFR gene was determined by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) for all of them. Results Patients of T2DM both without NAFL (96 case) and with NAFL had higher prevalence of hyperhomocysteinemia (Hhcy) (49% and 21%, respectively ) than normal controls did (4 cases, 8% ) (P<0.05), while patients of T2DM with NAFL had higher prevalence of Hhcy than those without it did (P <0. 05). Plasma level of Hey positively correlated to genotype frequency of the MTHFR gene, plasma 0levels of HbAlc and FBG in patients of T2DM, with coefficients of correlation of 0.248, 0.423 and 0.242, respectively (P < 0.05). Results of multiple logistic regression analysis showed that course of the disease, body mass index, plasma levels of FBG and Hcy all were independent risk factors for non-alcoholic fatty liver in patients with T2DM. Conclusions Hhey was an independent risk for non-alcoholic fatty liver and plasma level of Hey was influenced by frequency of the TT genotype of the MTHFR gene, plasma levels of FA and VitB12, as well as metabolic disturbance in patients with T2DM.