Objective To evaluate the application value of the VATS combined with artificial pneumothorax in extended thymectomy. Methods From March 2013 to November 2014, we completed 45 cases of expanded thymectomy in patients with myasthenia gravis .According to the choice of patients , the surgeries were divided into two groups .The artificial pneumothorax group (24 cases) was given thoracoscopic expanded resection under artificial pneumothorax , while the conventional surgery group (21 cases) was given conventional thoracoscopic surgery .The operation time , intraoperative bleeding , operative field show ( to expose the offside mediastinal fat and cardiophrenic angle fat fully ) and symptom relief were compared between the two groups . Results The operations were successful in all the 45 cases.As compared with the conventional surgery group , the artificial pneumothorax group had shorter operation time [(93.8 ±16.8) min vs.(119.5 ±23.3) min, t=-4.293, P=0.000], less intraoperative hemorrhage [(54.2 ±43.7) ml vs.(92.9 ±41.0) ml, t=-3.048, P=0.004] and better operation exposure [91.7% (22/24) vs.57.1%(12/21),χ2 =7.228, P=0.007].However, there was no significant difference in symptom remission rate between the two groups . Conclusion VATS under artificial pneumothorax for thymus expanded resection can fully expose the operation field , with shorter operation time and less blood loss .

Objective:To observe the clinical efficacy of rh-BNP combined with continuous renal replacement therapy on the re-fractory heart failure in cardiorenal syndrome. Methods:Totally 48 patients with refractory heart failure in cardiorenal syndrome in our hospital were selected and randomly divided into the observation group and the control group. The control group was received the con-ventional drug therapy combined with continuous renal replacement therapy, and the observation group was received rh-BNP therapy ad-ditionally. After 7 days, NT-ProBNP, heart rate, LVEF, SV, BUN, Scr and GFR of the two groups were compared, and the clinical efficacy of the two groups was evaluated. Results:After the treatment, all the observed indicators in the two groups were significantly improved than those before the treatment, and the improvement in the observation group was better than that in the control group ( P<0. 05). The total effective rate of the observation group was higher than that of the control group(91. 67% vs 79. 17%, P<0. 05). Conclusion:The combination of rh-BNP and continuous renal replacement therapy can improve heart and kidney function of the refrac-tory heart failure in cardiorenal syndrome with better efficacy.

Tracheotomy is an important auxiliary operation used in the perioperative period of the oral and maxillofacial (OMF) surgery. It plays an essential role in the success of the OMF operation and even in the recovery of the patients. According to the review of 126 cases of OMF operations with the perioperative tracheotomy during the past 27 years- by the authors and their team, the cases are classified into 3 types prophylactic, anesthetic and emergency tracheotomy. Indications for operation, complications in the postoperative period and their treatments are discussed. In conclusion and experience tracheotomy taker at the accurate time and well done is the key to achieve the success.

Hantavirus is the main cause of hemorrhagic fever with renal syndrome (HFRS). It is an acute infectious diseases characterized by fever, hemorrhage, nephritis or thrombocytopenia, and hantavirus pulmonary syndrome(HPS). The main clinical manifestations are fever, hemorrhagic lesion, acute respiratory distress and capillary leakeage syndrome. These are four different serotypes of the hantavirus species: Hantan virus(HTNV),Seoul virus(SEOV),Dobrava/Belgrade virus(DOBV),and Puumala virus(PUUV). They are known to cause HFRS, while Sin Nombre virus(SNV) causes HPS. In China, these are two serotypes of hantavirus: HTNV and SEOV found. The severity of infection depends on the viral serotype. To find a safe, rapid and specific serotyping diagnosis of the causative virus is important. The results not only can be beneficial for rodent control, but also for prevention and therapy. The current research of Hantavirus nucleocapsid protein used as serotyping antigen are summarized.

Objective To study clinical characteristics and CT features of cerebellar hemorrhage in the elderly patients in order to make early diagnosis and treatment. Methods The clinical characteristics, CT scan, sites and causes of hemorrhage, as well as the treatment and the prognosis of 32 elderly patients with cerebellar hemorrhage were analysed. Results The main clinical symptoms were vomiting, vertigo and headache and were observed in 32(100.0%), 26(81.2%) and 18(56.2%) cases, respectively. High motality rate was observed in hemorrhage volume≥25 ml, patients aged over 70 years and accomanied with cerebral hernia and multi-organ failure. Conclusions The clinical manifestations of cerebellar hemorrhage were not typical in the elderly. Cerebral hernia and multiple organ failure were the main causes of death. Hypertension and artherosclerosis were the main etiologies of cerebellar hemorrhage. The early diagnosis is necessary for the treatment of cerebellar hemorrhage. The prognosis was related to the quantity and site of hemorrhage.

9.0 mmol/L, and well controlled group if FPG0.05). However, in each group, the incidence rate of different algesic severity decreased with the increasing algesic severity. Conclusion EIP will occur in DM patients within a week after RCT. Well controlling of the blood glucose can reduce the incidence rate of EIP.

BACKGROUND:Lipopexia induced by glucocorticoid is fat precipitation in marrow due to abnormal lipomatabolism,or differentiation of cells resulting from hormone-affected bone marrow mesenchymal cells.The precise generating procedure remains unclear.OBJECTIVE:To Jnvastigate effects of vadous concentrations of dexamethasone on adipogenic differentiation of bone marrow mesenchymal cells.DESIGN,TIME AND SETTING:The observational study was performed at the Department of Biochemistry,China Medical University from January 2007 to January 2009.MATERIALS:A total of 80 Sprague-Dawley rats aged 3 or 4 weeks,weighing (110±10) g,of both genders,were used in this study.METHODS:Rat bone marrow mesenchymal cells were isolated and subcultured.Bone marrow masenchymal cells at the third passage were used as samples.MAIN OUTCOME MEASURES:Cellular morphologic changes after treatment of 10~(-7) mol/L dexamethasone were observed under an inverted microscope,as well as at 3,7,14 and 21 days under normal culture condition.Morphological changes of bone marrow mesenchymal cells were observed following alkaline phosphatase and Sudan Ⅲ staining.Alkaline phosphatase activity was measured using phenol reagent.Effects of dexamethasone on cell proliferation were measured using MTT assay.RESULTS:Following 24 hours of incubation,a few adherent cells were found in the bottom of the culture flask,showing spindle shape.With prolonged time,adherent cells became more,presenting radiated shape.Following passage,cells distributed uniformly,showing typical fibroblast-shape.Following dexamethasone stimulation,cells changed from spindle-shape into polygonal or irregular shape.In the late phase,with increased concentration and prolonged time,cell colonies disappeared;cells adhered,and died.In normal cultured cells,no or a few orange particles were found.In dexamethasone-cultured cells,with increased hormone concentration and prolonged time,Sundan Ⅲ stained particles increased.At 21 days,alkaline phosphatase activity under normal culture was separately 1.57-,4.49-and 5.0-fold of 10~(-8),10~(-7),10~(-6) mol/L dexamethasone group.At 7,14 and 21 days,alkaline phosphatase activity under normal culture was separately 2.93-,3.80-and 4.39-fold of 10~(-7) mol/L dexamethasone group (P ＜ 0.05).High concentration of dexamethasone had significant inhibitory effects on cell proliferation activity.Significant difference was detected as compared 10~(-7) mol/L and 10~(-6) mol/L to other groups (P ＜ 0.05).CONCLUSION:High-dose dexamethasone enhances adipogenic and suppresses osteoblastic differentiation of bone marrow mesenchymal cells.The effect will increase along with the increasing content and prolonged duration of demamethasone stimulation.

OBJECTIVE: To analyze the cost-effectiveness of 3 different therapeutic regimens for chronic urticaria.METHODS: 3 oral therapeutic regimens including regimen A(triprolidinen plus ranitidine),regimen B(levocetirizine),and regimen C(levocetirizine plus antipruritic) were analyzed using cost-effectiveness analysis.RESULTS: The total costs of regimen A,B,and C were 91.96 yuan,54.16 yuan and 356.56 yuan,respectively;The effective rates were 76.09%,74.00% and 91.84%,respectively;The cost-effectiveness ratios were 120.86,73.19 and 388.24,respectively.As compared with regimen B,the incremental cost-effectiveness ratios for regimen A and C were 1 808.61 and 1 695.07,respectively.CONCLUSION: Regimen C is the preferable one in terms of the cost-effectiveness.

Objective To investigate the diagnostic values of DCE-MRI quantitative evaluation of the activity of sacroiliac joints in ankylosing spondylitis.Methods Forty two patients (36 male and 6 female) with ankylosing spondylitis in our hospital were enrolled prospectively according to the standard of diagnostic criteria for ankylosing spondylitis revised in 1984.All of them were evaluated with the blood sedimentation,C-reactive protein and ankylosing spondylitis activity index (BASDAI).We divided the patients with ankylosing spondylitis into stationary phase group and active phase group.We analyzed each of the MRI images of the two patients groups using the extended Tofts model to determine the quantitative parameters of DCE-MRI,such as contrast transfer coefficient (Ktrans),reflux constant (Kep),extravascular extracellular volume fraction (Ve),plasma volume fraction (Vp).And then the differences of quantitative data between the two groups were compared.Spearman correlation analysis was performed between the parameters with statistically significant difference and BASDAI scores.Results Among the 42 patients,22 patients (18 male and 4 female) were in active phase group and the other 20 patients (18 male and 2 female) were in stationary phase group.Ktrans,Kep,Ve were (0.750± 1.130)/min,(1.008±0.732)/min,0.460± 1.735;(0.163±0.401)/min,(0.505 ± 0.902)/min,0.345 ±3.460 for active phase group and the stationary phase group,respectively.The results of the active phase group was significantly higher than the stationary phase group (Z=3.727,2.317,3.696,respectively;all P＜0.05).The Vp had no statistically significance for the active phase group (0.125 ± 0.310) and the stationary phase group (0.160 ± 0.329) (Z=1.209,P＞0.05).Strong correlations existed between Ktrans,Kep,Ve and BASDAI score,the correlation coefficients were 0.714,0.430,and 0.676 (P＜0.05).Conclusions Quantitative DCE-MRI parameters can evaluate the activity of the ankylosing spondylitis.Strong correlations exist between Ktrans,Kep,Ve and BASDAI score.

Purpose: Set up a new technique to reproduce the cavitation effect in the process of brain deceleration impact Methods: A transparent physical brain model with tiny air bubbles was built and loaded on an upright brain deceleration impacting moveable platform. Then, in the high strength lighting circumstance, the moveable platform was made to free fall from a height of 40cm and impacted on a fixed platform, and the whole deceleration impacting process was recorded by a high-speed video camera. Using the serial pictures analysing software, the volume and mean pressure change of the air bubbles were calculated and the cavitation effect of the brain tissue during the impact was studied. Results: The volume of the air bubble in the contrecoup site increased obviously in the impacting process, the volume of the air bubble in the coup site decreased in the impacting process and the volume change of the air bubble in the middle site was not evident enough in the impacting process. Conclusion: The results proved the negative pressure and the cavitation phenomenon in the contrecoup site. The experiments explicitly and directly showed the cavitation effect in the contrecoup site during the decelerating impact It was helpful to better understand the distribution characters of the dynamic stress of the brain tissue in the brain decelerating impact in a certain extent, and it could also provide some methods and experimental foundation to clarify the mechanical mechanism of the brain contrecoup injury which was often taken place in traffic accidental injury. Besides, the methods were of significance to research the biomechanism, diagnosis and prevention of the brain deceleration impacting injury.