This article is to report the result and experience of the clinical application of the extraluminal circumferential-suture ligation to close the bronchial stumps after pulmonary resections. This method was used for 469 times in 400 patients with various diseases including tuberculosis, lung cancer, and chronic suppurative disease with excellent results. After the use of this method, the incidence of the dreadful postoperative complication of broncho-pleural fistula was reduced to only 0.25%, and it never occurred when a main or a large bronchus was involved.It is pointed out that the advantage of this extraluminal circumferential-suture ligation method cannot be overemphasized and its success lies on two crucial steps as follows:1. The traditional open method to divide a bronchus is substituted with the new close method, which can avoid spraying the highly infectious bronchial contents into the pleural cavity to cause contamination. Thus the main source of infection is cut off.2. Every stitch of the circumferential suture is done extraluminally without penetrating the whole thickness of the bronchial wall or entering the infections bronchial lumen, which will further minimize the chance of infection.

The surveillance of schistosomiasis in three sites of Mianzhu City after earthquake showed that there were no infected Oncomelania snails and cases,but the emerging area with snails were 7 895 m~2.Therefore,the control measures should be strengthened.

This article is to report three cases of total anomalous pulmonary venous drainage(TAPVD). 2 out of the 3 cases were of the supracardiac form and they were corrected by anastomosis between the trunk of the pulmonary vein and the left atrium with excellent result. The third case was of the intracardiac form. The patient died in the late postoperative period of pulmonary venous obstruction due to the improper judgement during the operative procedure of compartmentalization. Meanwhile, the embryogensis, clinical manifestations, diagnosis, and operative proceduresfof TAPVD were reviewed and discussed.

One hundred and seven cases of tetralogy of Fallot (TOF) were surgically corrected in this institute in the period from Jan 1983 to Dec 1989. Adequate corrective procedures were performed in 106 cases and aorto-pulmo-nary shunt with 1.2 Dacron tube in one. The corrective procedures employed included simple intracardiac repair in 18, subpulmonary RV outflow patch in 50, transannular RV outflow patch in 37, and RV-PA coronary conduit in 1 because of anomalous right coronary artery. The operative mortality rate was 13% , and the main complication was low cardiac output syndrome (LCOS) , which occurred in 26 cases (24%) .It was found that the predisposing factors of LOS after corrective surgery for TOF were serious clinical manifestations of the patient before operation, and residual right ventricular outflow tract obstruction due to improper repair of the right ventricular outflow tract, which were fatal in some cases.

A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimiccarcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nestion, trabeculation, pseudoglandular, pseudopapillary, pseudofollicular, pseudorosetting and angiocentric patterns. Mucoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S-100 protein, NKIC3, HMB45, Melan A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, CD68, CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.

Objective To explore the diagnostic value of GP-/3 protein in gene detection in the patient of primary hepatic carcinoma, to discuss the joint roles of serum GP73 and AFP, and provide a novel method for the diagnosis for PHC and screening for high-risk population. Methods ELISA was used to detect the serum level of GP73 and AFP in 73 cases of PHC, 13 cases of hepatic cirrhosis, 32 cases of hepatitis and 62 cases of health people. SYBR Green real time fluorescence quantitative PCR was used to detect the relative value of GP73 mRNA in the peripheral blood cells of each group. Comparative Ct method was used to evaluate the relative expression levels. Eight cases of normal liver tissues and 8 cases of PHC tissues were detected at the same time to compare the relative expression levels. Results Kruskal-Wallis test showed that the serum levels of GP73 and AFP had significant differences between four groups(H value were 89. 6 and 52.0, P ＜ 0. 01) and the whole blood GP73 mRNA had no significant differences(H =4. 33, P ＞ 0. 05). Mann-Whitney test showed that the serum levels of GP73 had significant differences among PHC groups[166. 7 (162. 7-231.8) μg/L] and liver cirrhosis[57. 3 (46. 6-113. 6) μg/L], hepatitis[29. 6(26. 2-54. 5) μg/L], health group[25.1 (20. 8-29. 4) μg/L] (U value were 246, 297, 349, P ＜ 0. 01).The A FP levels of the four groups were 380. 9 (258.5-503.2) μg/L, 3.8 (1.3-14. 5) μg/L, 5. 1 (2. 4-7. 8)μg/L and 2. 8(2. 2-5.7) μg/L. It also showed significant differences (U value were 246,419 and 790,P ＜0. 01). The GP73 mRNA expression of PHC liver tissues(12. 64) was significant higher than normal liver tissues (1.00). The critical values for GP73 and AFP was determined to be 123. 2 μg/L and 10. 6 μg/L through the 8OC curves. Under the critical value the sensitivity of GP73 and AFP were 65.8% and 53.4% ,and the specificity of CP73 and AFP were 95.3% and 92. 5% respectively. Joint detection could increase the sensitivity up to 79. 5%, and achieve the high specificity of 90. 7%. Conclusions As a new diagnositic marker of primary hepatic carcinoma, GP73 protein has the very good sensitivity and specificity. The GP73 mRNA in the whole blood sample could not be used for the diagnosis of PHC. But it woule be a good molecular marker for diagnosis of PHC in the liver tissue sample. The joint detection of GP73 and AFP could improve PHC diagnostic performance, and provide an effective approcach to the PHC high-risk screening.

OBJECTIVE: To investigate the nasal sinus development and discuss the relation between sinusitis and nasal development. METHOD: One thousand seven hundred and five healthy children and 1424 children with sinusitis were selected randomly. All children underwent naso sinus computer tomography. Sagittal, coronal and transverse diameters of all sinuses were measured and statistically analyzed. RESULT: The measured sinus diameters of children with sinusitis were longer than that of healthy children (P < 0.01). Pearson analyses revealed a low correlation of age and the history of sinusitis (P < 0.01), and no correlation of gender and the history of sinusitis. There was moderate to high consistency between clinical diagnosis and nasal CT results about sinusitis (P < 0.01). CONCLUSION These results demonstrated that the differences of sinus development exist between the healthy children and children with sinusitis, and the sinus development in children with sinusitis were better than that of healthy children.
Adolescent ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Mucosa ; diagnostic imaging ; Paranasal Sinuses ; diagnostic imaging ; growth & development ; Sinusitis ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVE: In order to make a basis for the treatment of nasal sinuses of children and the correlated disease, we investigate the incidence rate of nasal sinusitis of children and explore the correlation between nasal sinusitis of children and CT in Kunming. METHOD: Two thousand one hundred and fourteen healthy children and 1535 children with sinusitis were selected randomly. Form whom were undergone nasal sinus computer tomography for different medical reasons. The incidence rates of nasal sinusitis in different age-groups were calculated and statistically analyzed. RESULT: The incidence rate of sinusitis was highest in 4 to 8 years old. There was moderate to high consistency between clinical diagnosis and nasal CT results (P<0.01). CONCLUSION These results demonstrate that the key stage of children's sinusitis prevention would be school-age children, and nasal CT scanning is helpful to evaluate the clinical condition.
Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Male ; Sinusitis ; epidemiology

Objective: To investigate the clinical effect and safety of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) in the treatment of previously untreated HBeAg-positive chronic hepatitis B (CHB) patients with a high viral load. Methods: A retrospective analysis was performed for the clinical data of 152 HBeAg-positive CHB patients with a high viral load (HBV DNA≥10⁶ IU/ml) who were firstly treated with ETV (ETV group) or TDF (TDF group), with 76 patients in each group. The serum levels of alanine aminotransferase (ALT), HBV DNA, HBeAg, anti-HBe, creatinine, and creatine kinase were measured at baseline, and the patients were followed up and evaluated at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96 of treatment. The Kaplan-Meier survival curves were used to analyze cumulative complete virologic response, HBeAg seroconversion, and ALT normalization rate. The Cox proportional hazards regression model was used to identify the influencing factors for virologic response. P < 0.05 was considered statistically significant. Results: There were no significant differences in ALT normalization rate between the ETV group and the TDF group at weeks 4, 12, 24, 48, 72, and 96 of treatment (18.1%/55.6%/83.3%/90.3%/93.1%/97.2% vs 16.0%/53.6%/75.4%/94.2%/100%/100%, P > 0.05). There were also no significant differences in virologic response rate between the ETV group and the TDF group at weeks 48 and 96 of treatment (89.5%/97.3% vs 93.4%/98.7%, P > 0.05). The multivariate analysis showed that the baseline parameters were not predictive factors for virologic response. At week 48 of treatment, the TDF group had a significantly higher HBeAg seroconversion rate than the ETV group (14.5% vs 3.9%, P = 0.048); at week 96 of treatment, there was no significant difference in HBeAg seroconversion rate between the two groups (15.8% vs 7.9%, P = 0.132). The Kaplan-Meier survival analysis showed that there were no significant differences between the two groups in cumulative ALT normalization rate, cumulative HBV DNA undetectable rate, and cumulative seroconversion rate. Only one patient in the ETV group experienced virologic breakthrough from weeks 60 to 72 of treatment, and there were no serious adverse reactions. Conclusion TDF and ETV had similar clinical effects, HBeAg seroconversion rate, and safety in previously untreated HBeAg-positive CHB patients with a high viral load.

OBJECTIVETo prepare a monoclonal antibody (mAb) against the fusion protein preM/EIII of West Nile virus (WNV) for clinical detection of WNV.

METHODSSp2/0 cells were fused with the spleen cells of BALB/c mice immunized with the recombinant fusion protein preM/EIII expressed in E. coil to obtain the hybridoma cell line that secreted preM/EIII mAb. The hybridoma cells were injected into the peritoneal cavity of BALB/c mice and the ascites was collected and purified. The specificity and titer of the obtained mAb were determined using ELISA and Western blotting.

RESULTSOne hybridoma cell line secreting preM/EIII mAb, named ME1, was obtained. The titer of the purified mAb was 10(-6). Identified as a mAb of the Ig subclass IgG1, ME1 was capable of specific reactions with preM/EIII protein and WNV without cross-reactions with other viruses such as JEV, SLEV, YFV and DENV. The accuracy of clinical testing of MNV with ME1 was 97.78%.

CONCLUSIONThe mAb against preM/EIII obtained have a high specificity and accuracy in clinical testing of MNV and can be used in clinical diagnosis of MNV infection.

Animals ; Antibodies, Monoclonal ; immunology ; Blotting, Western ; Cross Reactions ; Hybridomas ; immunology ; Mice ; Mice, Inbred BALB C ; Viral Fusion Proteins ; immunology ; West Nile virus ; immunology