Objective To evaluate the changes and clinic countermeasures of cough and expectoration in the patients with lung cancer after airway stent placements. Methods With the fibrobronchoscope, metal stents were placed in tracheas, main bronchia or right intermediary bronchia. It was compared that the degrees of cough and expectoration difficulties, the volumes and mucin content of sputa and lung functions before the placements, within 3 d and 1 to 2 months after operation. Results Within postoperative 3 days, the patients coughed more frequently, but VC, FEV_(1) and PEF were improved significantly. In postoperative 1 to 2 months, the degrees of cough were close to preoperative degrees, lung functions kept on improved conditions, but expectoration difficulties, volumes and mucin contents of sputa increased markedly, especially in the patients with tectorial membrane stents. Proper stents and reasonable treatment including use of antitussive, apophlegmatisant and antibiotics could decrease the degrees of cough within postoperative 3 days, and expectoration difficulties, volumes and mucin contents of sputa in postoperative 1 to 2 months. Conclusion To the patients with malignant central airway constriction, metal stent placement would improve ventilative functions but bring difficulties for cough and expectoration. The side complications would be relieved through corresponding treatments.

Objective　To investigate the effect of ipratropi um bromide and atropine on airway mucin hypersecretion in the chronic bronchiti s model of rats. Methods　The model was established by intratrac heal instillation of small dose of lipopolysaccaride (200 μg) ipratropium bromi de and atropine were administrated 3-21 d after the model was established. Patho logical changes, mucin in bronchoalveolar lavage fluid (BALF) and tracheal ring culture medium were examined before and after the adnsinistration of iprat ropium bromide and atropine. Results　Characteristic pathologica l manifestions of chronic brochitis were found after instillation of LPS. Sig nificant decrease in the number of tracheal epithelia goblet cells, secretion of mucin were observed in ipratropium bromide and atropine treated rats. The eff ect of inhibiting the secretion of mucin of ipratropium bromide was higher than atropine. Conclusion　It suggests that muscarinic acetylcholine receptor plays an important role in airway mucin hypersecretion in chronic bro nchitis model of rat. Ipratropium bromide exhibit a stronger inhibition effect on mucin hypersecretion than atropine, moreover no inhibition effect on mucocil iary clearance which was observed in atropine.

Objective To explore the association of lipid metabolism and bomocysteine with hypertensive disorders in pregnancy and observe the inflammatory reaction and the pathological change of placenta.Methods We conducted a prospective randomized placebo-controlled study.Seventy-four cases with hypertensive disorders in pregnancy were recruited as the experimental group and 77 cases of normal pregnant women were recruited as matched control group from Aug.2008 to Mar.2010.The relationship between lipid metabolism and homocysteine was analyzed.Results There was significant difference between the two groups in body-mass index before pregnancy(29.03±4.52 vs.23.99±5.90,t =5.88),cholesterol[(6.16±1.48)mmol/L vs.(5.01±1.05) mmmol/L,t =5.52],low density lipoprotein[(3.46±1.35) mmol/L vs.(2.26±0.86) mmol/L,t =6.54]and C-reactive protein[(29.04±14.90) mmol/L vs.(15.48±4.57) mmol/L,t =7.62](P ＜ 0.05).No significant difference was found on triglycerides[(3.29±1.03) mmol/L vs.(3.49±1.37) mmol/L],high density lipoprotein[(1.84±0.40) mmol/L vs.(1.88±0.35) mmol/L],homocysteine [(8.77±2.65) mmol/L vs.(8.40±2.03) mmol/L]and neonatal weight[(3547±519)g vs.(3431±461)g](P ＞ 0.05).Significant difference exists in placenta pathology of infarction(54.55％ vs.31.04％),villi dysplasia,fit nodules form and hypoxia(65.46％ vs.39.66％)(P ＜0.05).Conclusion We should detect lipid,homocysteine and C-reactive protein by dynamic combinational ways,pay more attention to women with high BMI before pregnancy,and value placenta pathology research on hypertensive disorders in pregnant women.This has high clinical significance in revealing the etiology of hypertensive disorders in pregnant women and improving pregnant outcomes.

Objective To study role of MDC/CCI22-CCR4 axis in mouse milky spots with peritoneal carcinomatosis of gastric cancer. Methods We examined the expression of CCR4 in 615 Mouse gastric cancer cell (MFC) lines by RT-PCR and Western-blot; Peritoneal metastasis model on the 615mouse was established by intraperitoneal injection of 0.2 ml MFC cells(1×104 cells). Dil fluorescence was used to observe the transfer process and section of MFC. Immunohistochemistry was conducted to detect the expression of CCR4 and CCL22 in omental milky spot; the structure of Milky spot was observed by scanning electron microscopy. Mice were randomly divided into 2 groups, namely, the saline control group (received saline) and MFC group. The concentration of CCL22 in ascitic fluid was measured in the 615 mice injected MFC after 6,8,10 days and in the saline group. Results MFC first metastasizes to the milky spot on the omentum, the expression of CCR4 and CCL22 were observered in the milky spot. The surface layer cells in milky spot consisted of discontinuous mesothelial cells and mainly macrophages and lymphocytes. The average value of CCL22 was 43 pg/ml and 364 pg/ml respectively in saline control group and MFC group.Conclusions MDC/CCL22-CCR4 axis plays an important role in the development of peritoneal carcinomatosis in mouse gastric cancer.

OBJECTIVE To investigate the time and dose relation of new urine bio markers in rat model of acute kidney injury induced by genta mycin (GM)to search for more sensitive,noninvasive and specific markers than traditional approaches to monitor nephrotoxicity.METHODS SD Rats were im treated with GM5,20,80 mg·kg -1 or saline once daily.Rats were randomly divided into 20 subgroups:treated for 1 ,3,7,14 d and 14 d followed with 28 d recovery period.Ten rats per group (5 rats per sex)were scarified at 24 h after the last dosing or the end of recovery period.Blood sa mples were col-lected for blood urea nitrogen (BUN)and creatinine(CRE)analysis.Urine was collected at each nec-ropsy for urine protein by dry che mistry method,for kidney injury molecule-1 (KIM-1 )analysis by ELISA, and for β2-microglobulin (β2-MG)analysis by ELISA.Kidneys were obtained for histological exa mination after HE stains.RESULTS Positive protein(3 +)was noted for several fe male animals treated for 7 or 14 d at 80 mg·kg -1 and the tendency of recovery were noted at the end of recovery period.Co mpared with those in saline control group treated for 7 d,the seru m BUN and CRE levels for fe males and the CRE level for males were significantly increased at 80 mg·kg -1 (P <0.05),and the BUN level showed the tendency of increase for males at 80 mg·kg -1 (P >0.05).When treated for 14 d,the seru m BUN and CRE levels for fe males and males at 80 mg·kg -1 and the seru m CRE level for fe males at 20 mg·kg -1 were significantly increased when compared with those in saline control group(P <0.05). The seru m BUN and CRE recovered to base line for all animals treated for 14 d followed by a 28 d recov-ery period.Histopathological observation of kidney tissues indicated that focal tubule dilatation was noted for animals treated for 3 d at 20 and 80 mg·kg -1 ,infla mmatory cell infiltration and focal tubule dilatation were noted at 20 mg·kg -1 and focal renal tubular epithelial cell degeneration,infla mmatory cell infiltra-tion,focal casts (lightly)were noted at 80 mg·kg -1 for animals treated for 7 or 14 d.For animals treated for 14 d followed by a 28 d recovery period,only basophilic tubules and renal casts were noted at 80 mg·kg -1 .New urine bio markers determination indicated that KIM-1 level was significantly increased at 20 and 80 mg·kg -1 for animals treated for 3,7 or 14 d when compared with that in saline control group (P<0.05).For animals treated for 14 d followed by a 28 d recovery period,the KIM-1 level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and males at 20 mg·kg -1 (P <0.05 ),but there was evidence for reversal.The β2-MG level was significantly increased at 80 mg·kg -1 for animals treated for 3 d(P<0.05),at 20 or 80 mg·kg -1 for animals treated for 7 or 14 d(P<0.05 or P<0.01 ),when compared with that in the saline control group.For animals treated for 14 d followed by a 28 d recovery period,the β2-MG level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and fe males at 20 mg·kg -1 (P <0.05),but there was also evidence for reversal.CONCLUSION Urine KIM-1 and β2-GM are more sensitive and specific markers for early diagnosis of kidney injury induced by GM when compared with the traditional approaches to monitor nephrotoxicity.

Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.

BACKGROUND:Synthetic patch as an important substitute to pelvic tissue can replace damaged pelvic fascia tissue, and has been widely used in the pelvic floor reconstruction. OBJECTIVE:To observe the efficacy and complications of pelvic floor reconstruction with mesh, and to explore its safety and effectiveness. METHODS: Forty-five pelvic organ prolapse female patients were divided into two groups according to patient’s wilingness: experimental group, pelvic floor reconstruction with mesh (n=25); control group, transvaginal hysterectomy combined with vaginal wal repair (n=20). Perioperative conditions were recorded, and uterine prolapse staging, complications, pelvic floor function, pelvic discomfort, as wel as an objective cure rate were evaluated in the two groups during the folow-up. RESULTS AND CONCLUSION:Compared with the control group, the experimental group was characterized as shorter operative time, less amount of bleeding, milder infections, and faster recovery (AlP < 0.05). At 6 months of folow-up, the score on uterine prolapse staging was higher in the experimental group than the control group; at 12 months, the scores on pelvic floor function and pelvic discomfort as wel as the incidence of complications were significantly lower in the experimental group (P < 0.05), but the objective cure rate was higher compared with the control group (P < 0.05). These findings suggest that pelvic floor reconstruction with mesh for pelvic organ prolapsed can reduce the operative time and blood loss and promote postoperative recovery. Meanwhile, it can significantly improve pelvic floor function, pelvic discomfort, postoperative complications, the rate of exposure, and the objective cure rate, which is safe and effective during the short-term folow-up.

Purpose To establish normative reference ranges of fetal azygos vein between gestation 20.0 and 40.0 weeks and analyze the possible correlation between azygos vein diameter and gestational age.Materials and Methods Retrospectively analyzed the data which collected from pregnant women with singleton pregnancies,1375 fetuses with normal outcome were included.The gestation was from 20.0 weeks to 40.0 weeks.The research objects were divided into 5 groups according to their gestational age and were examined standardized.The fetal normal reference value of azygos vein and its correlation with gestational ages were analyzed.Results The normal reference value of the fetal azygos vein diameter was established.We found that a significant increase linear between the diameter of fetal azygos vein and the gestation age.There was no obvious correlation with sex.The ratio of azygos vein and descending aorta inner diameter was about 0.36.There was on obvious changes in different gestational ages.Conclusions Fetal echocardiography technology can accurately assess fetal cardiac structure,the establishment normal reference value of azygos vein diameter could provide guidance for fetal echocardiography examination.

OBJECTIVE:To investigate therapeutic efficacy and safety of Acetic acid goserelin sustained-release implants (AGRI) in the treatment of ovary endometrium cyst (OEC) recurrence after laparoscopic enuleation of ovarian cyst. METHODS:Totally of 60 patients with OEC recurrence after laparoscopic enuleation of ovarian cyst in Zhangjiagang First People's Hospital dur-ing Jan. 2013-Jan. 2015 were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups were given Mifepristone tablets orally 25 mg,qd. Control group was given Gestrinone capsules orally 2.5 mg,twice a week. Observation group was given AGRI subcutaneously 3.6 mg,once a month. Both groups were treated for consec-utive 6 months. Clinical efficacies of 2 groups were observed as well as the levels of serum follicle stimulating hormone(FSH),lu-teinizing hormone(LH)and estradiol(E2),VAS scores of dysmenorrheal and chronic pelvic pain before treatment,3,6 months af-ter treatment. The occurrence of ADR and the prognosis of 12-month follow-up were observed in 2 groups. RESULTS:Total re-sponse rate of observation group was 86.67%,which was significantly higher than 70.00%of control group,with statistical signifi-cance(P<0.05). After 3 months of treatment,the levels of FSH and LH in 2 groups were decreased significantly compared to be-fore treatment,with statistical significance (P<0.05);the level of E2 had no change;there was no statistical significance in the levels of FSH and LH between 2 groups(P>0.05);after 6 months of treatment,the levels of FSH,LH and E2 in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). After 3 and 6 months of treatment,VAS score of dysmenorrheal and chronic pelvic pain in 2 groups were decreased signifi-cantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). The inci-dence of ADR in observation group was 40.00%,which was significantly higher than 16.70% of control group,with statistical sig-nificance(P<0.05). There was no statistical significance in recurrence rate between 2 groups(P>0.05). The recovery rate of men-struation in observation group was 86.67%,the rate of dominant follicle formation was 60.00% and pregnancy rate was 53.33%, which were significantly higher than 46.67%,46.67% and 33.33% of control group,with statistical significance(P<0.05). CON-CLUSIONS:AGRI shows significant therapeutic efficacy for OEC recurrence after laparoscopic enuleation of ovarian cyst,can ef-fectively relieve dysmenorrhea and chronic pelvic pain,increase the rate of pregnancy. There is still recurrent cases after drug with-drawal. The incidence of ADR is high,but the symptoms are mild.

Objective: To investigate the hyponatremia incidence in patients with ruptured intracranial aneurysms and the correlation with Fisher grading and cerebral vasospasm. Methods: Totally 150 patients with ruptured intracranial aneurysms from March 1998 to May 2001 were divided into anterior communicating artery (ACoA) group,posterior communicating artery (PCoA) group and middle carotid artery(MCA) group according to the sites of aneurysms.The patients were treated with GDCs interventionally and the incidences of hyponatremia were analyzed. Results: The incidences of hyponatremia in 3 groups were 48%(32/67),15%(8/52) and 16%(5/31),respectively; The incidences of severe hyponatremia of 3 groups were 30%(20/67),6%(3/52) and 6%(2/31), respectively. In ACoA group, the incidences of hyponatremia in Fisher grade Ⅲ-Ⅳ and Ⅰ-Ⅱ were 67%(20/30) and 32%(12/37) and the incidences with and without vasospasm were 71%(24/34) and 24%(8/33), respectively. Conclusion: The ACoA group has a significantly higher incidence of common and severe hyponatremia than the other groups. In ACoA group,hyponatremia is significantly more often in Fisher grade Ⅲ-Ⅳ cases and those with vasospasm.