Objective To study and compare the effects of different surgical operation in treatment of adolescent idiopathic seoliosis. Methods 70 patients with adolescent idiopathic seoliosis and patients informed consent were selected as research object,and they were divided into group A 35 cases and group B 35 cases according to their willingness, and they were separately treated with videoassisted anterior thoracoscopic correction and traditional anterior thoracoscopic correction, then the surgical time, complications, hospital stays, rates of patients satisfaction, total effective rate and Cobb, before and after the treatment were detected and compared. Results The surgical time [(225.6 ± 30. 8) min] and hospital stays [(2. 7 ± 0. 8) d] of group A were all shorter than those of group B [( 365. 4 ±23. 8) min, (4. 8 ± 1.2 ) d] ( t = 3.26,3.78, all P ＜ 0. 05 ), complications rate ( 8. 6% ) was lower than that of group B (20. 0% ) ( x2 = 3. 45, P ＜ 0. 05 ), rates of patients satisfaction ( 97. 1% ) and total effective ( 97. 1% ) were higher than those of group B(80. 0% ,85.75% ) (x2 =2. 85,3.01 ,all P ＜0.05) ,Cobb( 14. 2 ± 5.4)°was smaller than that of group B(23. 4 ±5.6) °(t =2. 97 ,P ＜ 0. 05). Conclusion The effect of vidcoassisted anterior thoracoscopic correction in treatment of adolescent idiopathic seoliosis was good,and complications rate was low and it was worthy of extend and application.

BACKGROUND: Studies about the mechanism of laser occlusion on the varicose great saphenous vein are rare.OBJECTIVE: To explore the ultrastructural changes of the great varicose saphnous vein after it was occluded with laser.DESIGN: An observational study.SETTING: Laser Department of the General Hospital of Chinese PLA .PARTICI PANTS: There were 42 patients with varicose great saphenous veins that were occluded with laser in clinic of the General Hospital of Chinese PLA from January to April 2004. The inclusive criteria: There must be obvious vein tangles beneath the undystrophic skin at ankle without apparent thrombus inside the vein. The patients involved should be voluntary to take part in the study. Finally 9 patients were enrolled in this study.INTERVENTION: The great saphenous vein was intravenously occluded with laser of 810 nm and the working power was 12 W and the exposure time was 1 s. The occluded vein sample was taken out 3 hours after the occlusion.MAINOUTCOME MEASURES: The ultrastrncture of the occluded vein was observed histopathologically. Normal vein and prereatment varicose vein served as control.RESULTS: The normal vein wall can be divided into 3 layers: the internal layer was composed of the simple endothelial cells; the median layer was composed of the smooth muscle cells, elastic fibers and collagenous fibers; the external layer was composed of the loose connective tissues. However, the internal layer of the varicose vein was incomplete, and the endothelial cells were loosely connected. The smooth muscle cells became hyperplasic, hypertrophic or atrophic. The elastic fibers decreased in number in contrast to the increase of collagenous fibers. After laser occlusion, in the vein lumen there was a large number of blood cells. The platelets became flattened with pseudopods and adhered to collagenous fibers. The endothelial cells and smooth muscle cells near the lumen were damaged and the cytoplasma leaked and fused with extracellular matrix. Broken collagenous and elastic fibers could be seen near the lumen and some were observed in the lumen. There was no structure change in the external layer and adjacent elastic fibers and collagenous fibers.CONCLUSION: Laser occlusion damaged the internal layer and part of median layer of the varicose vein, caused aggregation of the blood cells in the lumen and promoted the adhesion of platelets to vein walls.

BACKGROUND:The authors' experiments of the earlier stage proved that the hypocrellin B photodynamic therapy(HB-PDT) can cause selective injuries to choriocapillaries. It is not known whether changing the therapeutic parameters would gain a different result regarding the choriocapillaries after the hypocrellin B photodynamic treatment for a month.OBJECTIVE: To observe the features of Chinchilla rabbit choriocapillaries after HB-PDT treatment and to probe into the research prospect of using HB-PDT to treat choroidal neovascularization (CNV) and of using green light as the light source for PDT.DESIGN: A single sample study.SETTING: Laser Department of the Chinese PLA General Hospital.MATERIALS: The trial was conducted at the Laser Department and the Department of Pathology of the Chinese PLA General Hospital as well as the Department of Photoelectric Engineering of Beijing University of Science and Engineering. The materials included photosensitizing agent hypocrellin B (HB), a green laser transmitter, fundus fluorescence camera and transmission electronic microscope.METHODS: The 532 nm green laser transmitter and slit-lamp microscope were connected by light fiber. Chinchilla rabbits of 2.5 to 3.5 kg was narcotized generally and HB(1. 0 mg/kg) was injected into the marginal ear vein. HB was excited with the green laser of 532 nm. The power density of the light spot on fundus was 300 mW/cm2, and the energy density 30 J/cm2. Laser was applied immediately after HB injection and the diameter of the light spot was 2 000 μm. Direct observation of retina, fluorescein fundus angiography and observation with light microscope and electronic microscope were conducted on the 1st, 7th and 28th days respectively after PDT to find the biological features of retina and the choroid.MAIN OUTCOME MEASURES: Non-selective injury of retina through direct observation of the fundus; obliteration of the choriocapillaries detected through fluorescein fundus angiography; the position and extent of non-selective injury in retina and the structural changes of the choriocapillaries observed through the light microscope; the ultrastructural changes of the fundus observed through the electronic microscope.RESULTS: One day after PDT, photodynamic thrombosis was formed in choriocapillaries being illuminated and the external layer of retina was apparently injured. On the 7th day, injury of endothelial cells of the choriocapillaries was aggravated without obvious changes of the main vessels of choroid. On the 28th days, fibrous tissue appeared where the choriocapillaries had been and the glass membrane became thickened. Repair and proliferation of RPE cells appeared in the laser illuminated area.CONCLUSION: The biological effect in the target area and non-selective injury in the non-target area began to appear from the 1st to the 7th day after PDT and continued to aggravate. That would be repaired by fibrous tissues from the 28th day. It deserves further studies to treat age-related macular degeneration or other diseases in fundus characterized with choroidal neovascularization.

Objective:To investigate the status of professional identity among student nurses and explore its influential factors.Methods:A total of 1,302 student nurses from 3 universities of different levels in Shaanxi Province were selected using stratified and cluster random sampling method and investigated by adopting Professional Identity Questionnaire for Nurse Students (PIQNS).Results:Student nurses in Shaanxi Province scored (57.56 ± 12.55) in professional identity,of which the lowest was independence of career choice in the 5 dimensions.It showed that educational status,gender,and the reasons to choose nursing specialty correlated to student nurses' professional identity (P ＜0.05).Conclusions:The professional identity of student nurses especially for the undergraduate nurses is not high,which should cause the attention of the nursing educators and nursing managers to stabilize nursing team.

The crude toxin was extracted from hypha and culture solution of Phyllosticta commelimecola through three different polarity solvent: benzinum, puncificatum ethyl acetate and chloroform. The result indicated that the toxin secreted by Phyllosticta commelimecola not only was in hypha but also in culture solution and the extracting effect of ethyl acetate was the best. The soybean median and PSK media can be respectively used as solid and liquid culture media to produce toxin and grow mycelium. The optimal cultural conditions for producing toxin were temperature 32℃,cultured period 14d, cultured ways shaking of 150r/min.

Objective To discuss the predictive value of multiple ultrasonic features combination in diagnosis of thyroid papillary carcinoma (PTC) more than 1.0 cm in diameter. Methods The ultrasonic features of 258 PTC nodules from 251 patients and 207 nodular goiter (NG) nodules from 190 patients in the First People′s Hospital of Hangzhou were retrospectively analyzed. All the nodules were confirmed by pathological examination after surgery. The ultrasonic features included the shape of nodules, internal echo,anteroposterior/transverse diameter ratio (A/T), and microcalcification. The χ2 test was used to analyze the differences of ultrasonic features between PTC and NG. Multi-variate analyses (Logistic regression) was used to analyze the predictive risk ultrasonic features of PTC. The sensitivity and specificity of ultrasonic features were analyzed based on the gold standard of pathological results. Results There were significantly differences between 258 PTC nodules and 207 NG nodules in irregular shape, hypoechogenicity,A/T > 1 and microcalcification (χ2 values were 121.511, 105.411, 41.483, 121.072, all P < 0.01). The results of Logistic regression showed that irregular shape, hypoechogenicity, A/T>1 and microcalcification were risk ultrasonic features of PTC. And their OR values were 5.013 (95%CI 2.919-8.610), 5.811 (95%CI 3.411-9.901), 15.399 (95%CI 7.576-31.301), 4.141 (95%CI 1.687-10.164) respectively. The sensitivity and specificity of single ultrasonic feature were 26.0%-79.5% and 71.5%-96.1%; the sensitivity and specificity of two ultrasonographic features combination were 11.2%-57.0% and 92.3%-99.0%; and the sensitivity and specificity of three or four ultrasonographic features combination were 8.1%-31.8% and 99.0%-99.5%.Conclusions Irregular shape, hypoechogenicity, A/T> 1 and microcalcification of thyroid neoplasm are important ultrasonic features of PTC. Although the sensitivity of single ultrasonic feature in diagnosing PTC is higher than that of multiple features combination, it has a lower specificity. Therefore, combination of multiple ultrasonographic features can improve the specificity in diagnosing PTC and reduce the misdiagnosis of PTC.

Objective To investigate the potential of 99Tcm-Durarnycin and 99Tcm-RGD in detecting vulnerable plaque in rabbit models.Methods Fifteen healthy New Zealand male rabbits were randomly divided into group A (control group,n =5),group B (stable plaque group,n =5) and group C (vulnerable plaque group,n =5).Animals were injected with 99Tcm-Duramycin and 99Tcm-RGD at the end of 4,8 and 12 weeks.SPECT/CT scanning was performed at 0.5 h post injection.One rabbit was sacrificed at the end of 4 weeks and one at the end of 8 weeks after imaging.The others were sacrificed at the end of 12 weeks after imaging studies.All aortas were collected.Intravascular ultrasound (IVUS) was performed at the end of 8,12 weeks before SPECT/CT scanning.The data was analyzed with paired t test.Results In group A,the aortas had little uptake of the two probes.In group B,the aortas showed obvious radioactive uptake of 99Tcm-Duramycin and 99Tcm-RGD at the end of 8 weeks and 12 weeks,while 99Tcm-Durarnycin gave better display than 99Tcm-RGD.In group C,99Tcm-Duramycin uptake was higher than 99Tcm-RGD uptake in the aorta.The T/NT ratios of 99Tcm-Duramycin and 99Tcm-RGD in group C were 2.14±0.34 and 1.46±0.34 (t=4.072,P＜0.05) at the end of 4 weeks,2.93±0.41 and 1.66±0.22 (t=5.578,P＜0.05) at the end of 8 weeks,3.25±0.29 and 1.81±0.28 (t=19.692,P＜0.05) at the end of 12 weeks.In isolated specimen of group C,the yellow lipid plaque of the intima bulged on the lumen at the end of 12 weeks.IVUS indicated that,at the end of 8 weeks and 12 weeks,the endometrial thickness of group C was (450±104) mm and (767±52) mm (t=44.024,P ＜ 0.05) respectively,and the rates of luminal stenosis were (29.30± 2.81) ％ and (37.98 ±6.41)％ (t =9.226,P＜0.05).Conclusions Both 99Tcm-Duramycin and 99Tcm-RGD may be used to detect vulnerable plaque at early time.99Tcm-Duramycin may detect vulnerable atherosclerotic plaque earlier than 99Tcm-RGD and provide better diagnostic image.

Objective To study the effects of fluid loading during fluid resuscitation on hemodynamics and cerebral perfusion(CPP)under different levels of intra-abdominal pressure(IAP).Methods Forty swine were employed in the study.Hypovolemia was made by blood withdrawal of 30% of estimated blood volume from each animal through the carotid artery line.All swine were randomized(random number) into four groups, namely IAPL0, IAPL15, IAPL25 and IAPL35.Then N2 gas was used to inflate in the abdomen slowly for elevating the IAP to 0,15, 25 and 35 mmHg.Fluid loading were performed with 500 mL hydroxyethyl starch within 30 minutes.Hemodynamic variables were evaluated by PiCCO.Heart rate (HR),mean arterial pressure(MAP), central venous pressure(CVP), cardiac output(CO), global end-diastolic volume index(GEDVI) and stroke volume index(SVI)were measured 30 minutes before fluid loading and 30 minutes after fluid loading.After placement of intracranial pressure optical fiber probe in the ventricle connected to intracranial pressure monitor for continuous monitoring of ICP changes, cerebral perfusion pressure (CPP) could be calculated.Results (1)HR decrease, MAP increased, SVI, CI and GEDVI significantly increased after fluid loading in all four groups (IAPL0,IAPL15,IAPL25 and IAPL35)(P<0.05),and there were not significant changes in CVP and EVLWI(P>0.05).SVRI decreased significantly in group IAPL15,IAPL25 and IAPL35 respectively(P<0.05).(2) ICP increased significantly in group IAPL15, IAPL25 and IAPL35(P<0.05), and CPP increased significantly in group IAPL25 and IAPL35(P<0.05) while CPP only slightly increased in group IAPL15(P>0.05).Conclusion When combined with intra-abdominal hypertension,fluid loading could improve the circulation of swine due to increase in CO and improve CPP.

OBJECTIVE To evaluate the association between the results of skin prick test (SPT) of dust mites and serum specific IgE (S-IgE). METHODS A total of 170 patients with allergic rhinitis received SPT and detection of S-IgE of Der p and Der f. The positive rates and grades of S-IgE to different diameters of skin reaction or skin index (SI) were compared. RESULTS The positive rates and grades of S-IgE showed significant differences among different diameters of skin reaction or skin index (SI) patients. The positive rates and grades of S-IgE increased significantly according to the diameters of skin reaction or SI. CONCLUSION There is a significant association between SPT of dust mites and S-IgE.

Objective To retrospectively analyzed the echocardiographic characteristics of ventricular diverticula in fetuses ,children and adults ,and discuss the main points of diagnoses and prognoses of ventricular diverticula . Methods Echocardiographic characteristics ,clinical data and intraoperative findings of ventricular diverticula of 8 fetuses ,3 children and 14 adults were summarized . Results The ventricular diverticula in 8 fetuses and 3 children were all single . Twenty five diverticula were found in the 14 adult patients ;in other words ,there were 3 multiple diverticula found in adult group . A statistical difference was found in ratio of diverticula area and corresponding ventricular area ( P = 0 .021 ) ,and corresponding ventricular fractional shortening ( P =0 .003) between fetal and single adult ventricular diverticula . There were 2 cases with ventricular septal defects ,1 with pericardial effusion ,1 with single umbilical artery ,and 2 with atrioventricular valvular regurgitation in fetal cases . Congenital complex cardiac disease and dextrocardia were found in 1 child . There were 1 case with supravalvular aortic stenosis , 1 with nonobstructive hypertrophic cardiomyopathy ,1 with left ventricular noncompaction ,and 1 with mitral reguigitation in adult group . All the 7 diverticula with ventricular arrhythmias ,ST‐T changes and abnormal Q wave were fibrous type . And 2 multiple diverticula were accompanied with ventricular dysfunction . Among the fetal cases ,2 cases were born ,3 cases were terminated pregnancy ,and 3 cases were lost to follow up . Three children and 2 adults were underwent cardiac operations for diverticula with good outcomes . No such complications as cardiac rupture ,thromboembolism ,and sudden death were found . Conclusions Echocardiography is a useful method to diagnose ventricular diverticulum ,especially for fetuses ,and provide the basis for prognosis consultation .