Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

Actinomycosis ; diagnosis ; pathology ; surgery ; Adult ; Female ; Humans ; Ovarian Diseases ; diagnosis ; pathology ; surgery

In the face of both market competition and health logistic support,whether military hospitals can adapt their operation and management strategies to balance the relationship of battlefield and market place,is the lifeline of their survival and development.The study summarized significance of strategic management of the hospitals in view of characteristics of such hospitals,and introduced explorations made at the hospital in their strategic management.

The “vertical tongue”method was used in speech training for 12 patients with functional speech disorder of consonant /L/.Af-ter treatment,the average vocal intilligibility of the 12 patients increased from 86.3% to 98.9%(P <0.05)./L/consonant average intelligi-bility increased from 42.9% to 85.2%(P <0.05).

Objective To investigate the wake-promoting effect of vagus nerve stimulation (VNS) on coma rats after traumatic brain in-jury (TBI), and the related mechanism. Methods A total of 168 healthy Sprague-Dawley rats were randomly divided into blank group, TBI group, antagonist group and VNS group, 42 rats in each group. The latter three groups were established TBI model with impact, and the rats in coma at least 30 minutes were included. VNS group accepted VNS, the antagonist group were injected intralateroventricularly Orexin A receptor 1 (OXR1) antagonist SB334867, and TBI group accepted sham VNS. Their behaviors were observed to determine the level of con-sciousness six, twelve and 24 hours after intervention, while the expression ofγ-aminobutyric acid b1 receptor (GABAb1R) in prefrontal cortex was detected with immunohistochemistry and Western blotting. Results There were 42 rats in the blank group, 11 rats in TBI group, 13 rats in the antagonist group, and 28 rats in VNS group awakened finally. The expression of GABAb1R in prefrontal cortex ranged as TBI group, antagonist group, blank group and VNS group from more to less twelve and 24 hours after intervention under Western blotting (F>60.412, P<0.001), and it ranged as TBI group, antagonist group, VNS group and blank group under immunohistochemistry (H=15.121, P=0.002), with no significant difference among time points (H=3.028, P=0.220). Conclusion VNS can promote waking from coma in rats after TBI, which may relate with the decrease of GABAb1R in prefrontal cortex that induced by Orexin A.

Objective: To analyze influence of fluvastatin on carotid intima-media thickness (IMT) and pulse pressure (PP) in patients with essential hypertension (EH). Methods: A total of 62 EH patients were enrolled and randomly divided into fluvastatin group (n=32, received fluvastatin therapy based on routine antihypertensive therapy) and routine treatment group (n=30, received routine antihypertensive therapy). Course of treatment was one year for all patients. Levels of blood lipids, PP and carotid IMT were compared between two groups before, six and 12 months after treatment. Results: Compared with before treatment, there were significant decrease in levels of all blood lipids, PP [(66.9±7.3) mmHg vs. (53.1±6.2) mmHg] and IMT [(0.97±0.42) mm vs. (0.76±0.29) mm] in fluvastatin group after treatment six and 12 months, and significantly improved more than those of routine treatment group, P<0.05 all. The levels of above-mentioned indexes were no significant improvement in routine treatment group before and after treatment（P>0.05）. Conclusion: Fluvastatin can improve carotid intima-media thickness and pulse pressure in patients with hypertension and is worth extending in clinic.

Objective To compare different methods for developing rat model of the syndrome of cold fluid retention in lung ( CFRL) , so as to find an easier and more reliable modeling method for CFRL. Methods Twenty rats were divided into 4 groups, namely normal group, lipopolysaccharide (LPS) group, tobacco group, and cold bath group, 5 rats in each group. Lipopolysaccharide group was given intratracheal drip of LPS, tobacco smoking and cold bath, tobacco group was given tobacco smoking and cold bath, and cold bath group was given cold bath and intragastric gavage of cold water. The modeling time in the three groups lasted for 15 days. After the experiment, we compared the general health state, body weight, sputum volume and pathological changes in rats of the four groups. Results (1) Compared with the normal group, activities of rats in the three modeling groups were lowered, body temperature decreased, and the signs of panting, cyanotic nose and lips with excretion, and sneezing (cough) were obvious. (2) Compared with the normal group, the decrease of body weight was obvious (P<0.01), expelling sputum volume was increased (P<0.05) in the model groups. However, the differences among the three model groups had no statistical differences ( P>0.05). ( 3) The results of lung tissue slice examination showed that the injury of lung tissue was severe in LPS group, mild in tobacco group and slight in cold bath group. Conclusion Rat model of CFRL has been established successfully in all of the three modeling groups, and in consideration with all respects, the method for tobacco group is the best.

Adult ; Female ; Humans ; Lupus Erythematosus, Systemic ; enzymology ; Male ; Middle Aged ; Peroxidase ; blood

Objective To compare the pulmonary complications between the double lumen tube and the single lumen tube,and to determine whether there are objective advantages of one over the other in one-lung ventilation during minimally invasive esophagectomy(MIE).Methods From January 2012 to November 2013,165 patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.Results Between the single lumen tube and the double lumen tube:patients with pulmonary infection is 11 (16.42％),34(34.69％) (P =0.010).The average intubation time is(1.45 ±0.22)min,(6.53 ±0.59) min,P =0.000.The number of harvested lymph nodes of total is (42.76 ± 18.11) and (34.32 ± 15.80),P =0.002.The number of harvested lymph nodes of the cervix and the left laryngeal recurrent nerve chain was (3.19 ± 2.53) and (1.30 ± 2.14),P =0.000.Conclusion In the minimally invasive esophagectomy,single lumen tube is simpler and easier than the double lumen tube,and with the low incidence of postoperative pulmonary complications,at the same time there are more advantageous in the meditational lymph nodes cleaning.

Objective To explore the relationship between the CHADS2 score and short-term prognosis in acute ischemic stroke patients with nonvalvular atrial fibrillation. Methods Consecutive ischemic stroke patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after stroke were registered.Patients were divided into 3 groups on the basis of CHADS2 pre-stroke score (0 to 1,2,3to 6).And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS ≤ 2reflected good prognosis,and mRS ≥ 5 implicated unfavorable outcome).After screening the risk factors affecting prognosis using univariate analysis,the relationship between CHADS2 score and prognosis was estimated using logistic regression model.Results Of 203 patients enrolled,the CHADS2 score of 0-1,2,3-6 were present in 72,53 and 78 respectively.Patients with the higher CHADS2 score had a higher initial NIHSS score (9.8,12.6,13.0,F =3.404,P =0.008 ),more likely to receive nosocomial pulmonary infection( 12.5％,34.0％,39.7％,x2 =14.643,P =0.001 ),negatively related to good prognosis (x2 =28.542,P =0.000 ) and positively related to unfavorable outcome ( x2 =23.575,P =0.000 ).Logistic regression model results suggested that CHADS2 score was an independent predictor of good prognosis and unfavorable outcome. Compared with CHADS2 score 3-6, CHADS2 score 0-1 was independently associated with good prognosis ( OR =5.018,95 ％ CI 2.055-12.560 ).And compared with CHADS2 score 0-1,CHADS2 score 3-6 was independently associated with unfavorable outcome ( OR =6.197,95％ CI1.670-22.996 ).Conclusions CHADS2 pre-stroke score appears to be useful in prediction of stroke outcome for patients with nonvalvular atrial fibrillation.After acute ischemic stroke,the patients with the lower CHADS2 score (0-1) are more likely to achieve good prognosis,inversely,the patients with the higher CHADS2 score (3-6) are more likely to achieve unfavorable outcome.