What characterized post-thoracotomy pain is that companied by marked decrease in pulmonary function,which negatively affect rehabilitation of the patients.In this paper,the author reviewed the effects of clinically common used therapies on pain relief and pulmonary function in patient after thoracotomy.

To investigate risk factors and efficacy of reoperation for neovascular glaucoma ( NVG) secondary to vitrectomy in proliferative diabetic retinopathy (PDR).
●METHODS:Seven cases (7 eyes) from October, 2009 to December, 2012 were analyzed retrospectively. All the patients had NVG after the primary vitrectomy for PDR and were performed secondary vitrectomy combined with laser photocoagulation .
●RESULTS: The mean intraocular pressure ( lOP) was (11. 21±4. 22)mmHg before primary surgery. The number of laser spots ranged from 622 to 1124 during the first vitrectomy. Cataract extraction was performed in all 7 cases and intraocular lens was implanted in 5 cases. The mean lOP was (10. 11± 3. 62) mmHg during 2mo after the primary surgery. During follow- up, all the patients had significantly progressive intraocular inflammation. Vitreous hemorrhage was not absorbed completely in 2 cases and recurrent vitreous hemorrhage occurred in the other 5 cases. Five cases had poor glycemic control and the other 2 cases had bad blood pressure control. NVG occurred in all 7cases. The mean lOP was (41. 13 ± 7. 76) mmHg before the secondary surgery. After the secondary surgery, the lOP were under control in 5 cases. For the other 2 cases, the lOP was controlled in one case by transscleral cyclophotocoagulation, another one was lost in follow-up with uncontrolled lOP.
●CONCLUSlON: Primary vitrectomy combined with lens extraction, insufficient laser speckle, unabsorbed and recurrent vitreous hemorrhage, intraocular inflammation and systemic condition may be the risk factors associated with the occurrent of NVG after vitrectomy in PDR. Secondary vitrectomy combined with sufficient retinal photocoagulation is efficiency for NVG after vitrectomy for the PDR.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Histiocytosis, Sinus ; pathology ; surgery ; Humans ; Immunoglobulin G ; blood ; Paranasal Sinus Diseases ; pathology ; surgery ; Paranasal Sinuses ; pathology ; S100 Proteins ; metabolism ; Sclerosis ; pathology

Objective To investigate clinical feature, diagnosis and treatment of tuberculosis infection in renal transplant patients. Methods To analyze clinical data of 13 patients suffering from tuberculosis infection after renal transplantation retrospectively. Results Twelve patients got lung tuberculosis while only one lymphoid tuberculosis. They were unequivocally diagnosed as tuberculosis by radiological plain film, searching acid-fast bacilli in sputum repeatedly, detecting DNA of Bacillus tuberculosis by PCR and biopsy, 4 of whom had mixed infection in lung. Eleven patients recovered after standard antituberculosis therapy, but 2 died. Hepatic function lesion was main adverse reaction in treatment, but it could get normal after adjustment of immunodepressant. Conclusion Tuberculosis incidence rate in renal transplant patients increased obviously. Standard antituberculosis therapy is effective, but immunodepressant should be adjusted in time according to the change of hepatic function and renal function.

After the advantages of PACS system in medical imaging examination were described, its rational appli-cation in medical imaging examination was elaborated .

用秩和比法对37例脑瘫患者施行SPR术中影响应激反应的诸因素进行分析。结果显示：3—6岁小儿、切断后根小束大于50％者、电刺激量平均为5．1—10mA者、芬太尼量大于3μg／kg·h者和于腰骶部行SPR者应激反应最强。3、4级痉挛者、芬太尼量为2．1—3μg／kg·h者、7—13岁儿童、切断后根小束41—50％者和电刺激量平均大于10mA者应激反应较强。5级痉挛、14岁以上青成年和电刺激量平均小于5mA者，应激反应较弱。而芬太尼量小于2μg／kg·h、切断后根小束少于40％和行颈胸段SPR者应激反应最弱。经临床分析，作者提出：SPR中应特别注意6岁前小儿及切断后根小束超过50％的脑瘫患者的应激反应。

ObjectiveTo compare the effect of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on pulmonary function in post-thoracotomy patients.Methods33 ASA Ⅰ～Ⅱ patients undergoing selective esophagectomy were randomly divided into the PCEA group (n=16, treated with morphine plus bupivacaine) and PCIA group (n=17, treated with morphine plus droperidol) for 3 days postoperatively. Pulmonary function indices including respiratory rate (RR), tidal volume (Vt), vital capacity (Vc) and pulse oximetry (SpO2) were recorded before operation and on the first 2 days after operation. Pain scores with visual analogue scale (VAS) at rest, deep breathing and with cough, and adverse effects were also recorded.ResultsRR increased, Vt , Vc and SpO2 decreased markedly in both groups postoperatively compared with the base line (P<0.01), but there were no significant differences between two groups. VAS scores were much lower in PCEA group, especially, when the patient was at deep breathing or during coughing (P<0.001).ConclusionPCEA is superior to PCIA in pain relief, but contributes no more than PCIA in improving pulmonary function in post-thoracotomy patients.

ObjectiveTo compare the effects of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomit (PONV) in gynecologic and obstetric patients. Methods56 gynecologic or obstetric patients (ASA Ⅰ～Ⅱ) scheduled for lower abdominal surgeries were randomly allocated to receive either 1 mg/ml morphine plus 0.1 mg/ml droperidol intravenously (group PCIA) or 0.1 mg/ml morphine plus 0.125% bupivacaine (group PCEA-Ⅰ) or 0.1 mg/ml morphine plus 0.1 mg/ml droperidol plus 0.125% bupivacaine (group PCEA-Ⅱ) epidurally. 4, 24, and 48 h after operation, pain scores with visual analogus scale (VAS), sedation scores with Ramesay and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. ResultsVAS scores in the two PCEA groups were much lower than that of PCIA (P<0.01). The incidences of nausea and vomiting in PCEA-Ⅱ group were significantly lower than those in PCIA group (P<0.05), incidences of other side-effects such as pruritus, respiratory depression etc. were similar between the three groups (P>0.05). ConclusionThe regimen morphine/droperidol/bupivacaine by PCEA shows superiorities in relieving pain and reducing postoperative nausea and vomiting in gynecologic and obstetric patients.

Objective To analyze the clinical features of pure red cell aplasia (PRCA),and to improve the recognition of its pathogenesis and treatment.Methods Among 35 PRCA patients from 1990-01 to 2003-04 in our hospital,17 patients(group Ⅰ) had immunologic abnormality,and the other 18 patients (group Ⅱ)were normal at every immunologic index.Removed the primary affection,all patients were given the combine treatment with drugs:androgen,immunosuppressive agent or/ and glucocorticoid.Results Nine patients in group Ⅰ appeared T subgroup ratio inversion in peripheral blood,eleven patients had higher level than normal with TNF?,and six patients' IL-2 level was higher.The response was 70.6%.Some patients shifted to normal in immunologic index.The response was 86.7% in group Ⅱ.But 11 cases relapsed of the 25 cured and remission patients.They responded again to the initial therapy.Conclusion Dysimmunity is the most important pathogenesis in PRCA patients.Most patients respond to immunosuppression therapy.The relapse patients also respond to initial therapy.

Objective To compare the analgesic effect, adverse effects of patient-controlled epidural analgesia (PCEA) vs patient-controlled intravenous analgesia (PCIA) and their influences on stress response in thoracotomy patients. Methods 33 ASA I-II patients undergoing elective esophagectomy were randomly assigned to receive either morphine plus droperidol (Group PCIA, n=17) or morphine plus bupivacaine (Group PCEA, n=16) for 3 days postoperatively. Serum concentrations of cortisol, angiotensin Ⅱ (Ang Ⅱ), endothelin (ET) and blood glucose were measured before operation, at the end of the operation and on the next morning after operation. Pain scores with visual analogue scale (VAS) at rest, deep breathing and with cough, and adverse effects were also recorded. Results Blood glucose and cortisol were increased to similar levels in both groups at the end of the operation, but were much lower in Group PCEA postoperatively (P0.05). Pain scores with VAS were much lower in Group PCEA, especially when the patient was at deep breathing or during coughing (P