Clinical manifestations thoracoscopy findings,and pathological findings of 54 patients with tuberculous pleural effusion were reported.The gross appearance of pleural lesions under direct vision with thoracoscope can be divided into three types:(A) tuberculous nodules in 34 cases,all of them were proved by pathological examination;(B) Inflammatory reaction type in 14 cases,in whom rate of positive pathology was 78.5% (11/14);(C) pleural hyperplasia and adhesion type in 6 cases,and rate for positive pathology was 66.7% (4/6).Of these 54 patients,the overall rate for positive pathoiogy was 00.75% (49/54).The diagnosis and pathogenesis of tuberculous effusion were discussed.The presence of characteristic tuberculous nodules on the pleura with specific pathological finbings suggets that direct invasion of pleura by tubercle bacilli may play a more important role than pleural allergic reaction in the pathogenesis of tuberculous pleural effusion.

Laser ablation of hard tissue allows very precise pre-programmed incisions with complete free geometry and it has advantage of leaving no tissue damages. Those disadvantages of thermal side effects and low cutting rates had been overcome by introducing ultra-short pulses and ultra-power laser systems. This review highlights the recent advances in the laser ablation of hard tissues.

Objective To discuss effect of compound Xueshuantong capsule in in treatment patients of cataract with proliferative diabetic retinopathy.Methods 60 cases of cataract patients with proliferative diabetic retinopathy from February 2015 to February 2016 in our hospital were selected,according to random number table method divided into observation group (n=30) and control group (n=30).The patients in both groups were given basic medical treatment of diabetes,the patients in observation group were treated with Xueshuantong capsule before cataract surgery,continue treatment for three months.The total effective rate of treatment was compared between the two groups,the results of fundus fluorescein angiography and macular thickness before and after treatment were compared,comparison the levels of VEGF in the aqueous humor of the two groups after the treatment. Results The total effective rate of treatment in observation group was significantly higher than control group (P<0.05).After treatment, the number of hemangiomas in the observation group was significantly less than that in the control group (P<0.05),the area of exudation was significantly smaller than that of the control group (P<0.05),the macular thickness of the observation group was significantly lower than the control group (P<0.05),the VEGF content in aqueous humor was significantly lower than that in control group (P<0.05).Conclusion Compound Xueshuantong capsule can significantly improve the retinopathy of cataract patients with proliferative diabetic retinopathy,has a significant effect on decreasing VEGF concentration in aqueous humor and reducing macular edema .

Objective To study the diagnostic value of mammography and high-frequency ultrasound in diagnosis of early breast carcinoma.Methods Sixty-five female patients with breast carcinoma were all confirmed by surgery and pathological examinations. All the patients were examined by the high-frequency ultrasound as well as mammography.Results The positive diagnostic rate,the display of tumor shadow and malignant microcalcification with high-frequency ultrasound and mammography were as follows :64.6%(42/65)and 46%(30/ 65),62%(40/65)and 20%(13/65),40%(26/65)and 20%(13/65)respectively. The difference was considered statistically significant(P

12. 9 mg/dl) were compared to 298 newborn with low serum bilirubin level randomly selected from the remaining 503 subjects. Results High bilirubin level was significantly associated with brease feeding, pregnancy induced hypertension of mothers, loss of birthweight, and high hematocrit( P

Objective To evaluate the clinical value of tumor chemosensitivity test in the guidance of the advanced epithelial ovarian carcinoma patients treated with chemotherapy.Methods Women with ovarian cancer were enrolled and fresh tissue samples were collected for chemoresponse testing.Oncologists chose a drug for each patient according to the patient’ s condition by double blind method.Each treatment was classified by the assay as: sensitivity (S); moderate sensitivity (I);resistant (R).Progression-free survival (PFS) and overall survival (OS) were detection.The relationship between treatment response and PFS or OS was analysis.Results 262 patients were enrolled.The PFS and OS were significantly improved in sensitivity patients (S) after chemotherapy,but no significant difference were found in I and R groups.In I+R groups (HR=0.66,P=0.008) , median PFS was 8.9 months, OS was 5.8 months.Chemotherapy response test results was consistent with clinical results cisplatin sensitive and resistant ( HR:0.72 vs.0.66).Multi factor regression analysis showed that tumor chemosensitivity test was independent prognostic factors (HR =0.66, P =0.021).The average OS extended for 14 months (37.6 months for the S group vs.group I +R 23.8 months,HR =0.62, P =0.011).Conclusion Tumor chemosensitivity assay is correlated with the clinical effects and might play an important role in guiding the recurrent epithelial ovarian cancer patients with individualized chemotherapy.

Objective:To investigate the clinical, pathological, and prognostic characteristics of luminal B breast cancer patients with diabetes. Methods:A total of 479 luminal B breast cancer patients with diabetes and 3 392 luminal B breast cancer patients without diabetes who were treated between January 2002 and December 2006 were enrolled in this study. The luminal B breast cancer patients were further divided into the luminal B (high ki67) and luminal B (Her-2/neu+) subgroups. Each subgroup was further grouped into metformin-treated, non-metformin-treated, and non-diabetic groups. The indicators included cancer-specific mortality, clinical, pathological stage, lymph node status, chemotherapy, and endocrine therapy. The survival analysis of each group was performed using the Kaplan-Meier method, and the significance was determined using the logrank test. Cox proportional hazard model was used to examine the correlation between each factor and the prognosis. Results:The Kaplan-Meier analysis results revealed that the breast cancer mortality rates in the metformin-treated, non-metformin-treated, and non-diabetic groups were significantly different in both luminal B (high ki67) and luminal B (Her-2/neu+) subgroups (logrank test:P<0.001, P=0.035), and the respective five-year survival rates were 93.5%, 81%, and 89%for the luminal B (high ki67) subgroup and 84%, 77%, and 83%for the luminal B (Her-2/neu+) subgroup. The Cox multifactorial regression analysis results showed that compared with the metformin-treated group, the non-metformin-treated group was associated with a significantly increased risk of mortality (P<0.001, P=0.044) in the two subgroups. Meanwhile, the non-diabetic group was associated with an increased risk of mortality (P=0.038) in the luminal B (high ki67) subgroup only. The percentage of elderly (P<0.001), menopausal (P<0.001), obese (P<0.001), and patients with cardio-cerebrovascular complications (P<0.001) tended to be higher in the metformin-treated and non-metformin-treated groups than in the diabetic group. Moreover, the metformin-and non-metformin-treated groups in the luminal B (high ki67) subgroup were associated with high percentages of T3/4 pathological stage (P<0.001), lymph node metastasis (P=0.001). The non-metformin-treated group was associated with a lower percentage of invasive ductal carcinoma (P=0.001) compared with the other two groups. Conclusion:The non-metformin-treated group resulted in worse clinical outcomes in both subgroups compared with the metformin-treated group. Meanwhile, the non-diabetic group resulted in the worst prognosis among the three groups in the luminal B (high ki67) subgroup. These findings suggest that the choice of different anti-diabetic drugs may influence the prognosis of luminal B breast cancer patients with diabetes.

Objective To summarize the clinical features and possible impacts of Goodpasture's syndrome in pregnancy on the pulmonary and kidney of the newborn and the mothers. Methods One patient diagnosed Goodpasture's syndrome in pregnancy hospitalized in Peking Union Medical College Hospital on August 23 in 2011 delivered a neonate with bullae of lung. And literatures including 8 cases of pregnancy complicated by Goodpasture's syndrome worldwide through Medline were reviewed. Results (1) Case report:one 31-year-old women presented with acute renal failure at 30+6 weeks of gestation and delivered a male infant with birth weight 1 900 g by caesarean section at 31+1 weeks of gestation. Diagnosis was confirmed as Goodpasture's syndrome with anti-glomerular basement membrane(GBM) antibodies in serum and renal biopsy after delivery. Then she was treated with methylprednisolone, cyclophosphamide, plasmapheresis and dialysis. The neonate showed the lung bullae in the right middle lobe and bilateral intraventricular hemorrhage but renal function was transient normal with anti-GBM as 113.1 EU/ml. The baby was treated by glucocorticoid for two months and clinical symptoms were improved. Anti-GBM antibodies and chest CT showed normal. After been followed up for two years, the baby was normal. (2) Literatures review:the main manifestations of Goodpasture's syndrome in pregnancy were malignant hypertension and renal failure but respiratory symptoms were not obvious. Treated with plasmapheresis, hematodialysis and glucocorticoid maybe have good effects. Most cases had premature delivery. Neonatal anti-GBM antibodies coming from mothers could result to cerebral, renal and pulmonary injury which could be treated by glucocorticoid. Conclusions The Clinical features of pregnancy complicating the Goodpasture's syndrome are malignant hypertension and renal failure. Diagnosis was depended on positive anti-GBM antibodies and renal pathological changes and treatment were depended on plasmapheresis, hematodialysis and glucocorticoid. Neonatal cerebral, renal and pulmonary injury resulting from anti-GBM antibodies coming from mothers should be followed up, and glucocorticoid should be taken if necessary.

Corneal transplantation has been considered a primary method for treatment of keratopathy. Corneal transptantation would bring immunological rejection although cornea belongs to an immune-privileged tissue owing to no vessels and lymphatic vessels. Immunological rejection is highly likely to occur in keratopathy patients who undergo large sizes of corneal transplantation or present with newly formed vessels in the center of implant. Many patients have to replace other implants because of immunological rejection. But severer immunological rejection caused by several corneal transplantations as well as rare donor source can not satisfy patients' requirement. Therefore, much attention has been paid to studies regarding drugs for immunologic protection following surgery. There have been many clinical studies confirming that the principle drugs against immunologic rejection, such as glucocorticoid and ciclosporin A, can not acquire satisfactory curative effects and concomitantly bring many adverse reactions. For this reason, many new immunosuppressive agents should be investigated. The method of drug combination has become an important research project for keratopathy physicians.

BACKGROUND: Human apolipoprotein H which characterizes by polymorphism is related to metabolism of triacylglycerol (TG) and function of platelet; therefore, it is suspected that it is possibly related to coronary atherosclerotic heart disease (CAHD).OBJECTIVE: To investigate the correlation among apolipoprotein H(ApoH) exon-8 polymorphism with CAHD and its effect on lipometabolism.DESIGN: Case-controlled observation.SETTING: Department of Cardiology, Haici Medical Group, Qingdao,Shangdong. PARTICIPANTS: 110 CAHD patients selected from Qingdao Haici Medical Group were regarded as CAHD group, and other 100 healthy subjects were regarded as control group.METHODS: 2 mL blood was collected from peripheral vein of all cases. Polymerase chain reaction and technique of restriction fragment length polymorphism were used to determine the genotype of ApoH exon-8; meanwhile, lipids were measured with oxidase technique.MAIN OUTCOME MEASURES: ① polymorphism of ApoH exon-8 genotype; ② gene frequency of ApoH exon-8 (Try316Ser); ③ comparisons of lipid level of cases with various genetypes.RESULTS: All 210 cases were involved in the final analysis. ① G1025C (Try316Ser) existed in ApoH exon-8, including types of GG and GC, butnot CC type. ② The frequency of GC in the CAHD group was 25.5％, and the frequency of C allele was 0.13; they were significantly higher than those in control group (10％, 0.05, P ＜0.05). ③ TG level in genotype GC of CAHD group was significantly higher than that both in GG genotype and in any genotype of control group [(1.38±0.24), (1.16±0.10),(1.09±0.78), (1.12±0.76) mmol/L, P ＜ 0.05]. Level of low-density lipoprotein cholesterol (C-LDL) was higher in CAHD group than that in control group (P＜0.05).CONCLUSION: The polymorphism of ApoH exon-8 is closely related to CAHD and TG level.