Objective:To summarize the curative effect in treatment of Raynaud's syndrome with chemical thoracic sympathectomy(CTS) guided by X-ray since 2001.Methods: From March 2001 to August 2007,97 patients with Raynaud's syndrome(186 limbs) were treated by CTS.Guided by X-ray,a needle was punctured through the back skin to the second thoracic sympathetic ganglion beside the thoracic vertebrae and 2 mL of 5%(v/v) phenol was injected.Results: The first CTS treatment produced a good effect on 146 limbs with an effective rate of 78.5%(146/186).The same treatment was performed on the limbs with no effect 1-2 days after the first treatment and produced good effect on 13 limbs with an effective rate of 32.5%(13/40).The total effective rate of the patients who were hospitalized for the first time was 85.5%(159/186).Of the 97 patients,78 patients(80.4%) were followed up for 47 months on an average with an effective rate of 69.5%.And the rate of complications was 11.4% for pheumothorax,and 3.9% for hydrothorax.Hyperalgesia on axillary region and anterior chest wall;Horner syndrome and sinus bradycardia were rare.Conclusion: CTS is minimally invasive and effective in treatment of Raynaud's syndrome.

Objective To investigate the safety and feasibility of femoral vein thrombectomy for patients with acute deep vein thrombosis in the lower limbs.Methods During June 2003 to August 2006,a succession of 43 patients with acute deep vein thrombosis in the lower extremities received femoral vein thrombectomy in our hospital.An inferior vena cava filter was employed before the operation.Anticoagulation and regional thrombolysis were taken postoperatively.Analyse the data of operation procedure,curative effect and complications.Results The operation time ranged from 55 to 115 minutes with a mean of 92.6 minutes.Four of the patients received blood transfusion during the operation.The mean blood loss was 384.6 ml (100 to 1000 ml).Five patients showed transient fluctuation of blood pressure during the surgery.None of the patients had pulmonary embolism during and after the operation. Five patients developed lymph leakage from the incision at the inguinal area,and was cured in 1 week.One aged patient suffered from postoperative postatic pneumonia and was cured before being discharged;no other complications were found in this series.The thrombectomy achieved good outcomes in our patients.The edema and pain in the lower limbs were relieved quickly after the operation, the difference between the circumferences of the two legs decreaed from a median of 5.5 cm (thigh) and 4.0 cm (crus) to 1.5 cm and 1.0 cm (Z=-5.345,P=0.000 and Z=-5.461,P=0.000),respectively,32 of the patients received re-examination 6 months postoperation,none of them showed recurrent thrombosis.Conclusions Femoral vein thrombectomy is feasible and safe for serious acute deep vein thrombosis in the iliac and femoral veins.Patients can recover quickly after the operation.

Objective To observe the clinical efficacy of acupuncture in treating subjective tinnitus.Method Seventy subjective tinnitus patients were randomized into a treatment group and a control group, 35 cases in each group. The control group was intervened by conventional medication, while the treatment group was by acupuncture in addition to the medication given to the control. The serum zinc level, copper level, and pure-tone hearing threshold were observed before and after intervention, and the clinical efficacies were compared.Result After intervention, the serum zinc and copper levels, and pure-tone hearing threshold were significantly changed in both groups (P<0.05). The serum zinc and copper levels, and pure-tone hearing threshold of the treatment group were significantly different from that of the control group after intervention (P<0.05). The total effective rate was 93.8% in the treatment group versus 87.9% in the control group, and there was a significant difference between the two groups (P<0.05).Conclusion Acupuncture plus medication is an effective way in treating subjective tinnitus.

Objective To evaluate the prognostic value of urine paraquat (PQ) concentrations combined with poisoning time and creatinine clearance rate (CCr) on prognosis of patients with acute paraquat poisoning (APP). Methods A retrospective case control study was conducted. Clinical data of 96 patients with APP admitted to Department of Emergency of Shengjing Hospital of China Medical University from March 2014 to May 2016 were analyzed. The gender, age, body weight, urine PQ concentrations (determined by semi-quantitative colorimetric method), poisoning time (time from oral poison to urine detection) and CCr of patients were collected, and poisoning index (poisoning index = urine PQ concentrations × poisoning time/CCr) and simplified poisoning index (simplified poisoning index = urine PQ concentrations × poisoning time) were calculated. The patients were divided into death group and survival group according to 2-month outcome after poisoned with clinical data and telephone follow-up. The urine PQ concentrations, poisoning index, and simplified poisoning index between the two groups were compared. Binary classification logistic regression was used to analyze the risk factors affecting prognosis. Receiver-operating characteristic curve (ROC) and diagnostic test were used to analyze the prognostic value of the parameters. Results Compared with survival group, the urine PQ concentrations [mg/L: 30.00 (10.00, 100.00) vs. 10.00 (3.00, 10.00)], poisoning index [mg·h-1·μmol-1: 12.72 (1.86, 33.75) vs. 0.56 (0.18, 1.12)], and simplified poisoning index [mg·h-1·L-1: 600.00 (150.00, 1 000.00) vs. 60.00 (18.00, 120.00)] in death group were significantly increased (all P < 0.01). It was shown by logistic regression analysis that both urine PQ concentrations [odds ratio (OR) = 1.046, 95% confidence interval (95%CI) = 1.006-1.087, P = 0.022] and poisoning index (OR = 1.353, 95%CI = 0.029-1.815, P = 0.031) were independent risk factors affecting the prognosis of patients with APP. It was shown by ROC curve and diagnostic test that the poisoning index had greater area under ROC curve (AUC was 0.902) for evaluating the prognosis of patients with APP. When the best cut-off value was greater than 1.23 mg·h-1·μmol-1, the sensitivity was 90.91%, and the specificity was 73.08%. The AUC of urine PQ concentrations for evaluating the prognosis was 0.759. When the best cut-off value was greater than 20.00 mg/L, the sensitivity was 63.64%, and the specificity was 76.92%. The AUC of simplified poisoning index for evaluating the prognosis was 0.846. When the best cut-off value was greater than 135.00 mg·h-1·L-1, the sensitivity was 81.82%, and the specificity was 76.92%. Conclusion The poisoning index calculated with urine PQ concentrations combined with poisoning time and CCr has prognostic value for prognosis of APP patients, and the prognostic value of poisoning index is greater than that of the urine PQ concentrations alone.

Objectives To observe the expressions ofα-smooth muscle actin (a-SMA) and type III collagen (Col-III) of tubuloin-terstitial ifbrosis(TIF) induced by unilateral ureteral obstruction (UUO) in rat and the intervention effect of supplemental hydrogen sul-ifde (H2S). Methods Ninety-six male Sprague-Dawley rats were randomly divided into 4 groups, sham-operated group, UUO model group, NaHS low-dose group and high-dose group. TIF rat model was established via UUO. After UUO operation, low-dose and high-dose group were intraperitoneally injected twice a day with 1.4μmol/kg and 7.0μmol/kg NaHS, respectively. Sham-operated group and UUO model group were given an equivalent volume of normal saline. Eight rats in each group were killed randomly at 7, 14 and 21 days after UUO operation. The concentration of plasma H2S was detected using deproteinization. Renal tubulointerstitial damage was evaluated with routine Hematoxylin and Eosin staining and Masson staining under microscope. The expressions ofα-SMA, Col-III were measured with immunohistochemistry. Results Compared with sham-operated group, renal tubulointerstitial injury was severer in UUO model group and was alleviated after intervention of NaHS. There was signiifcant difference in tubulointerstitial injury among all groups (P<0.01), but no difference was found between high-dose and low-dose group. Exogenous H2S supplement could down-regu-late the expressions ofα-SMA and Col-III in renal tissues (P<0.05). There was no difference between high-dose and low-dose group in the expressions ofα-SMA and Col-III (P>0.05). Conclusions TIF induced by UUO is associated with decreased level of endogenous H2S. H2S supplementation can ameliorate the development of UUO-associated TIF in part through down-regulating the expressions ofα-SMA and Col-III in renal tissues. However, a dose dependent manner between the two doses of exogenous H2S supplementation was not observed.

To evaluate multi-slice computer tomography (MSCT) in mediastinal lymph node metastasis of T1 and T2 non-small cell lung cancer (NSCLC). Methods:A total of 32 patients with T1 and T2 NSCLC from February 2004 to October 2012 were selected. Preoperative MSCT assessment of mediastinal lymph nodes was performed on basis of the pathological results. Results:Lymph nodes with diameters of≥10 mm were evaluated, and the sensitivity and specificity of the MSCT mediastinal lymph node me-tastases were 82.4%and 92.4%, respectively. Lymph node size, primary tumor location, and visceral pleural invasion showed statistical significance in forecasting mediastinal lymph node metastases (P<0.05). Conclusion:MSCT can be used for the effective evaluation of mediastinal lymph node metastasis, lymph node size, and position of primary tumor. and visceral pleural invasion of the tumor had a higher risk of mediastinal lymph node metastasis.

[ ABSTRACT] AIM: To study the protective effects of cannabinoid CB2 receptor agonist JWH133 on rat acute lung injury induced by paraquat (PQ).METHODS: Male Sprague-Dawley rats (n=72) were randomly divided into 4 groups.PQ group:PQ was administered intraperitoneally at the dose of 20 mg/kg;Low-dose JWH133 pretreatment group ( L-JWH133 group):JWH133 (5 mg/kg, ip) was administered 1 h before PQ exposure;high-dose JWH133 pretreatment group ( H-JWH133 group):JWH133 (20 mg/kg, ip) was administered 1 h before PQ exposure;control group:1 mL sa-line was administered intraperitoneally.Arterial blood, bronchoalveolar lavage fluid (BALF) and lung tissue samples were collected at 8 h, 1 d and 3 d after PQ exposure.PaO2 and the levels of TNF-αand IL-1βin BALF were measured via blood gas analyzer and ELISA, respectively.The pathological changes and lung injury scores were assessed at 3 d after PQ expo-sure.NF-κB and AP-1 protein levels were also determined by Western blotting.RESULTS:The decrease in PaO2 , struc-tural injury of the lung tissues, interstitial pulmonary edema, and the increase in IL-1βand TNF-αin BALF were observed in PQ-treated rats compared with control group.JWH133 pretreatment reduced the degree of lung tissue injury, decreased the levels of IL-1βand TNF-αin BALF and the NF-κB and AP-1 protein expression in the lung tissue compared with PQ group, especially in H-JWH133 group.CONCLUSION:CB2 receptor agonist JWH133 inhibits NF-κB and AP-1 protein expression in the lung tissues, and reduces the secretion of IL-1βand TNF-αin BALF after paraquat exposure, thus atten-uating paraquat-induced acute lung injury.

Objective Tubulointerstitial fibrosis(TIF) is the most important marker reflecting the degree of renal function decline and prognosis and hydrogen sulfide ( H2 S) is crucial in maintaining normal renal function and many diseases of renal injury. The aim of the article was to investigate the effects of exogenous H2 S on the expressions of angiotensinⅡ ( AngⅡ) , proliferating cell nuclear antigen (PCNA) and transforming growth factor beta-1 (TGF-β1) in rats with unilateral ureteral obstruction (UUO). Methods TIF rat model was built with UUO. Ninety-six SD rats were randomly divided into four groups:sham operation group, modelgroup, UUO+low-dose NaHS treatment group ( low dose group) and UUO+high-dose NaHS treatment group ( high dose group) ( n=24, respectively) . Rats in model group were treated with left-side ureteral obstruction and ureteral separation without obstruction was done in sham operation group. UUO rats in two treatment groups were injected intraperitoneally with two different doses of sodium hydrosulfide (NaHS, donor of endogenous H2 S), respectively. HE and Massonstaining and immunohistochemical staining were performed at the 7 d, 14 d and 21 d, respectively. Results In sham operation group, the expressions of AngⅡ, PCNA, and TGF-β1 were found in microamount in tubulointerstitium at each time points. Compared with sham operation group, the expressions of AngⅡ, PCNA and TGF-β1 in model group increased( P<0.01) . While in comparison to model group, the expressions of AngⅡ, PCNA and TGF-β1 decreased in low dose group and high dose group, but no significant differ-ence was found between low dose group and high dose group. Conclusion Exogenous H2 S supplementation can attenuate TIF partly via downregulating the expressions of AngⅡ, PCNA and TGF-β1 .

OBJECTIVE Explore the waysof cochlear implantation(CI)surgery technique for bilateral profound sensorineural hearing loss patients with otitis media and mastoiditis. METHODS CI was performed in 29 patients with different of otitis media and mastioditis,26 of them underwent a single-stage operation,and 3 had a two-stage operation,according to the degree and extent of lesion. For patients with mild inflammation,cochlear implantation was performed after complete eradication of inflammation at the same protocol the patients with severe inflammation underwent an intact canal wall tympanomastoidectomy or reconstructed it initially,cochlear implantation was performed after the initial procedures. RESULTS One- stage or tow-stage operations of CI were carried out for 29 patients with otitis media and mastoiditis. All electrodes were implanted successfully,in which the CI went normally and electrode array were protected well. None of the cases showed recurrence of infection during an average follow-up period of 2-8 years. CONCLUSION The CI could be performed in otits media and mastoiditis patients after reversionary surgery . Individual management based on the degree and extent of the local lesion was emphasized.

Objective To study the expression and regulation characteristics of aquaporin water channel(AQP) of cerebuller metastatic tumor and brain tissue surrounding tumor and to understand the role of abnormal expression of AQP in formation and elimination of brain edema.Methods The tumor tissue specimens from five lung adencarcinoma brain metastasis cases after surgical resection were accessed.The total RNA was extracted,and RT-PCR,immunohistochemical staining were progressed to study the expression and regulation characteristics of AQP.The average gray values of near and far regions from tumor tissue were measured with HPIAS-1000 cells measuring procedure to compare actual expression quantity of AQP.Results AQP4 had a high expression in the peritumoral brain tissue and no expression in the center of brain metastasis tumor organization.The AQP4 staining was junior in the more distant region from tumor and it added significantly in the region close to the tumor tissue.Stained AQP1 was not found in cerebullar metastatic tumor and peritumoral brain microvascular endothelial cells.Conclusion The expression of AQP4 is increased significantly in the region next to the cerebullar metastatic tumor tightly.It is probably related to the formation of peritumoral brain edema.The negative expression of AQP1 might not be conducive to the removal of edema in the interspace of nerve cells.