0.05),But induced distraction had lower positive (t=3.060,P=0.014) and negative priming effects (t=3.527,P=0.006) for positive faces than induced rumination.(2) In induced rumination task,depressed individuals had lower positive (F=21.56,P=0.000) and negative priming effects (F=34.17,P=0.000) to negative faces than normal controls.(3) In induced distraction task,depressed patients had lower positive (F=51.97,P=0.000) and negative priming effects (F=10.21,P=0.000) to positive faces than controls.And it had lower positive priming effects (F=4.07,P=0.014) and negative priming effects (F=9.70,P=0.000) to negative faces than normal controls.Conclusion Induced rumination has no influence on inhibition of distraction in depressed individuals.Induced distraction decreases the distracter inhibition and increases the excessive facilitation for positive faces stimuli.

Objective To compare the outcomes of two temperature maintenance strategies during radical resection for carcinoma of oesophagus and their effects on postoperative shivering. Methods Thirty ASA Ⅰ-Ⅱ patients undergoing radical resection for carcinoma of oesophagus were randomly assigned to hypothermia group (HT group, patients were not wanned perioperatively, n=10), intraoperative normothermia group (INT group, patients were warmed only intraoperatively, n=10) and perioperative normothermia group(PNT group, patients were warmed before induction of anesthesia and during anesthesia, n=10). The tympanic temperature began to be recorded 20 min before induction of anesthesia at intervals of 10 min. Results There was no significant difference in the decrease velocity of tympanic temperature during the first hour after induction of anesthesia between HT group and INT group, while both were significantly higher than that of PNT group (P<0.05). There was no significant difference in the tympanic temperature within 70 min after induction of anesthesia between HT group and INT group, while both were significantly lower than that of PNT group (P<0.05). The tympanic temperature of HT group continued to decrease 70 min after induction of anesthesia, while that of INT group and PNT group began to increase. There were significant differences in the tympanic temperature 80 min to 180 min after induction of anesthesia among these three groups(P<0.05). The incidences of postoperative shivering were 8, 5 and 2 in HT group, INT group and PNT group, respectively. The scores of thermal comfort scale were 19±10, 41±7 and 51±11 in HT group, INT group and PNT group, respectively, and there were significant differences among these three groups(P<0.05). Conclusion Compared with INT, PNT can more effectively maintain perioperative normothermia, reduce the incidence of shivering and relieve the patients' cold thermal discomfort in radical resection for carcinoma of oesophagus.

Benzene ; isolation & purification ; Environmental Monitoring ; Occupational Exposure ; prevention & control ; Recycling ; Toluene ; isolation & purification ; Xylenes ; isolation & purification

Objective To study pathological diagnostic value of forceps and brush biopsy cytological examination by percutaneous transhepatic cholangiodrainage(PTCD) for malignant obstructive jaundice.Methods From April 2005 to April 2006,24 cases of obstructive jaundice underwent PTCD and stent insertion in biliary tract.Tissue pathological examination by forceps and brush was done during PTCD.Results 24 cases received forceps biopsy,of whom,14 cases received brush cytological examination at the same time.All of the 24 cases of forceps biopsy obtained pathological tissue and the pathological results as follows: adencarcinoma in 15 cases,4 cases had allotype cells,regarded as positive results;inflammation tissue in 1 case,which was restenosis after stent insertion;fibrous tissue in 1 case;tissue obtained was cholangioepithelia in 3 cases,in which 1 case was diagnosed as lymph node metastasis of peripheral head of pancreas after gastric cancer operation,2 cases were diagnosed as cholangiocarcinoma,the positive rate of forceps biopsy being 79.2%(19/24).4 cases of cytological examinations by brush showed tumor cells in 2 cases,allotype cells in 2 cases,regarded as positive results,the positive rate being 28.6%(4/14),and others were negative results.Conclusions Intracholangio-biopsy by PTCD offers the advantages of simplicity,safety,higher accuracy and less complications.Pathological diagnosis can be obtained at the same time during reducing-jaundice therapy by PTCD.

Objective:To explore the clinical application in urinary system stones of the inspection technologies intravenous pyelography (IVP),computer tomography urography (CTU) and magnetic resonance urography (MRU). Methods:We collected 100 cases of urinary system stones on which 80 were carried out to IVP,60 to CTU and 35 to MRU,25 patients were implemented all 3 examinations. CTU and MRU are reconstructed with multi-level reorganization (MPR),curved projection reproduction (CPR),volume reproduction (VR) and the maximum intensity projection (MIP). Results:Stones were found in 73 patients of the 80 people by IVP,the diagnosis rate is 91.3 %. Stones were found in all the 60 patients except 1 by CTU with images direct and accurate,the diagnosis rate was 98.1 %. By the MRU,stones were found in 20 of the 35 patients at a display rate of 57.1 %,with images displayed in a low stone location signal,filling defect and the hydrocele circs of renal pelvis and ureter. Conclusion:IVP is a simple method,easy-to-patient acceptance and has a high detection rate of stones; CTU has a good image quality and the detection rate is higher than the stone IVP. By combining with the original cross-sectional image,the rate of diagnosis is up to 98%; as a non-invasive and no contrast agent approach,MRU is also very important in the diagnosis of stones.

[Objective]To discuss the causes and preventive measures about complications of iliac crest bone graft harvesting.[Method]From Jan.1990 to Jan.2005,828 patients with iliac crest bone graft harvesting were reviewed retrospectively,their complications were taken statistical analysis.[Result]Fifteen patients were found with superficial infections;10 deep infections;20 patients with superficial seromas and 10 patients with minor hematomas;4 deep hematomas;30 nerve injuries;3 vascular injuries,all 3 cases occurred secondary to harvesting of posterior iliac crest bone grafts;1 donor defect hernias,and 2 iliac wing fractures.[Conclusion]The causes of complications are incorrectly harvesting and rude operation.The preventive measures are that operators should know the anatomic characteristic of ilium and microinvasion.

Objective To explore relationships of expression of hypoxia?inducible factor?1α(HIF?1α), vascular endothelial growth factor(VEGF)and protein kinase B(P?Akt)with angiopoiesis and cell apoptosis. Methods Biopsy specimens were collected from skin lesions of 32 patients with lichen planus and normal skin of 20 patients with lipomyoma, and subjected to paraffin embedding. Immunohistochemical staining was performed to measure expression of HIF?1α, VEGF and P?Akt, and TUNEL technique was used to detect apoptosis of keratinocytes in these paraffin?embedded tissue sections. Microvessel density (MVD)was assessed by counting CD34?labeled vascular endothelial cells. Results HIF?1α, VEGF and P?Akt were moderately or strongly expressed in lichen planus lesions, but absent or weakly expressed in normal skin of controls, and the expression of HIF?1α, VEGF and P?Akt was significantly higher in the lichen planus group than in the control group (all P < 0.01). HIF?1α was mainly expressed in nuclei of keratinocytes, while VEGF and P?Akt were expressed in the cytoplasm of keratinocytes. In addition, the lichen planus group showed significantly increased MVD(21.27 ± 6.54 vs. 10.26 ± 1.10 microvessels/high?power(200 ×)field, t = 5.607, P < 0.01)and apoptosis rate of keratinocytes(72.81% ± 9.234% vs. 28.16% ± 3.464%, t = 8.431, P < 0.01) compared with the control group. Pearson correlation analysis showed that there were positive correlations between HIF?1αand VEGF expression, between VEGF and P?Akt expression, and between P?Akt and HIF?1αexpression in the lichen planus group(r=0.625, 0.453, 0.455, respectively, all P<0.01), and expression of HIF?1α, VEGF and P?Akt was all positively correlated with MVD(r=0.721, 0.646, 0.671, respectively, all P<0.01). Conclusion HIF?1αand its downstream target genes VEGF and P?Akt may play a certain role in the occurrence of lichen planus.

The incidence of adenocarcinoma of the esophagogastric junction ( AEG) is rising rapidly in recent years. AEG as an independent disease different from squamous cell carcinoma of the esophagus and gastric adenocarcinoma is getting acknowledged for most of scholars, with the distinctive anatomy location and involute recurrence and metastasis style. A higher rate of relapse and poor prognosis after resection become conscious since most of patients have been diagnosed with advanced disease, and adjuvant chemoradiotherapy needs to be valued further. But so far, there is no clinical data and subgroup analysis aimed at the value of postoperative treatment for AEG specially, leading to controversy is remaining in patients could get benefit from postoperative treatment, and delineation of the radiation target, etc. The design of the irradiation target should in terms of the clinical?pathological characteristics of the AEG, Siewert'''' s subtypes, the lymph node metastasis mapping and recurrence characteristics after surgery.

Objective To study the clinical feature and original diseases of bone marrow granulomas. Methods A total of 5217 bone marrow biopsies were retrospecitively analyzed in Peking Union Medical College Hospital from January 2001 to December 2007. Results Bone marrow granulomas were present in 20 cases, representing an incidence of 0.38% in the series and an annual incidence of 2. 9 cases per year. Finally, 13 of these cases (65%) were diagnosed with tuberculosis. Hematological neoplasms and viral hepatitis were found in 4 and 2 cases respectively. Acute interstitial nephritis was diagnosed in one case. Conclusions The finding of a granuloma in a bone marrow biopsy is not common and unspecific.Tuberculosis, hematological neoplasms and viral hepatitis are the most common underlying diseases. Bone marrow biopsy is an important method for the diagnosis of disseminated tuberculosis.

ObjectiveTo study the effect of adding various doses fentanyl to 0.75％ bupivacaine for spinal anesthetic in the population undergoing inguinal hernia repair surgery. MethodsThe population of 100 patients belonging to ASA class Ⅰ and Ⅱ ,scheduled for elective inguinal hernia repair, were randomized to receive a spinal anesthetic with 2 ml 0.75％ bupivacaine and 1.0 ml saline (group B),or 50 μg/ml fentanyl 0.1,0.2,0.4,0.6 ml(group BF5, group BF10, group BF20,group BF30),each group with 20 cases.Subarachnoid block was established in the left lateral position in L2-3 space by use of a midline approach. The volume of injected drug was kept constant at 3 ml. The time to the highest level of sensory block, the time for regression until T12 level, the time for complete motor recovery, the maintenance duration of the analgesia,the anesthesia effect of the groups, duration of surgery, drug-related side effects were assessed and recorded.ResultsThe time of the highest level of sensory block in group BF30 was shorter than that in group B,group BF5, group BF 1 0, group BF20 (P ＜ 0.05 ), but group B and group BF5 was longer than group BF10,group BF20, group BF30(P ＜ 0.05 ). The time of regression to T12 level in group BF20 was longer than that in group B, group BF5, group BF10, group BF30 (P＜0.05),but group B and group BF5 was shorter than group BF10, group BF20, group BF30(P＜ 0.05 ). The time for complete motor recovery and the maintenance duration of the analgesia in group B and group BF5 was shorter than that in group BFI0,group BF20, group BF30 (P ＜ 0.05 ). The occurrence of pruritus in group B (0) was lower than that in group B F5 (8 cases),group BF10 (3 cases), group BF20 (6 cases), group BF30 (6 cases)(P＜0.05). There were no cases of respiratory depression in five groups. ConclusionsIt suggests that in the population receiving spinal anesthetic for hernia repair surgery, addition of 10 μ g fentanyl to 0.75％ bupivacaine significantly improves the quality and duration of analgesia. No further advantage occurs if the dose of fentanyl is increased among 30 μg.