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.

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 evaluate the effects of magnetic attachment keepers on MRI images.Me-thods:In in vitro part,keepers of MAGFIT EX 400,MAGFIT EX 600 and MAGNEDISC 800 magnetic attachment systems were cast into standard root-caps with different alloy respectively,including nickel-chromium alloy and gold-palladium alloy,or not be cast for contrast.In in vivo part,volunteers with keepers in different position and amount were included.All the specimens and volunteers were imaged by a Siemens SONATA 1.5-T MRI scanner.Extent of the artifacts in every slice was measured.The magnitude of the artifacts and the distortion of the anatomic structures were compared.Results:All kinds of keepers being studied produced obvious MRI artifacts.The extent of MRI artifacts induced by MAGFIT EX 400 keepers,MAGFIT EX 600 keepers and MAGNEDISC 800 keepers are 158.94 mm,168.52 mm and 173.00 mm,respectively.The images of mental region,tongue,palate,jawbone and sinus were evidently obscured by artifacts in all cases.When keeper was put in the molar region,the keeper-related MRI artifact may obscure the imaging of brain,spinal cord.SE sequence with right-left frequency-encoding direction was more desirable in MRI for the patients with magnetic attachment keepers.Conclusion:Keepers of magnetic attachment system did induce obvious artifacts in MRI examination.

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.

SUMMARY Tuberculous aneurysm of the aorta is a very rare disorder. There have been only 50 reported cases of tuberculous aneurysm since 1895 till now, of which 88% were false aneurysms with majority being single in number. And only four were found to have multiple tuberculous aneurysms. The mean ages of the patients were 50?16 years. Treatment of tuberculous aortic aneurysm must be a combined medical and surgical approach. Once tuberculous aneurysm is identified, surgery must be performed promptly. The size of the aneurysm does not influence the need for surgery. A 70-year-old male with intermittent episodes of abdominal pain after receiving an inappropriate antitubercular therapy for pulmonary tuberculosis was diagnosed as multiple false tubercular aneurysm of abdominal aorta. An aneurysm of base 3.3 cm and greatest diameter 5 cm?6 cm was seen just above the opening of Coeliac trunk. Also at the dorsal aspect of abdominal aorta and superior mesenteric artery junction and ventral aspect of renal artery false aneurysms were seen, each with the size of 1 cm in diameter. Apart from antitubercular and antimicrobial treatment, first line surgery Endovascular Exclusion of Abdominal Aortic Aneurysm was performed for ruptured false abdominal aortic aneurysm. Even before the second line surgery, smaller abdominal aortic aneurysms got ruptured and the patient ’s party gave up further treatment. Finally the patient died of gastrointestinal haemorrhage.