Objective With the popularization of low dose chest CT examination,a large number of patients with pulmonary nodules(10 mm ＜ D≤20 mm) or small nodules(4 mm ＜ D≤10 mm) emerged.How to accurately position pulmonary nodules especially small nodules in video-assisted thoracoscopic surgery(VATS) is the key.This study explores the positioning method for small pulmonary nodules in VATS.Methods From January 2012 to June 2014,we used a method named clock dial integrated positioning in 316 patients with pulmonary nodules who underwent limited resection or lobectomy in VATS,obtained satisfactory results.Results The accuracy of clock dial integrated positioning method in judgments was 99％ (313/316).296 cases underwent thoracoscopic sublobectomy,including thoracoscopic pulmonary segmental resection in 141 cases and thoracoscopic wedge resection in 155 cases.20 cases underwent thoracoscopic lobectomy.Among them 17 cases had multinodules which were in the different pulmonary segments of the same lobe.Underwent thoracoscopic lobectomy.The positions of 3 cases were error during early cases,underwent VATS lobectomy.The postoperative pathology:194 cases were lung cancer.37 cases were metastatic tumor.85 cases were benign lesions.Conclusion Combined with the clinical treatment experience,we believe that the clock dial integrated positioning method is effective for positioning in VATS.Clinical VATS experiences accumulations are also needed.

Objective To compare the effect of postoperative analGesia of the continuous femoral nerve block analGesia( CFNB),continuous epidural analGesia( CEA)and intravenous analGesia( CIA)for patients with total knee arthroplasty. Methods The clinical informations of l44 four patients who underwent line unilateral total knee replacement surGery from April 20ll to May 20l2 were retrospective analyzed. AccordinG to the way of postoperative analGesia,the patients were divided into different CFNB Group( n=70 ),CEA Group( n=36 )and CIA Group(n=38). Record the pain score of 24 h,48 h and 72 h after surGery and adverse reaction. Results VAS score of CFNB Group and CEA Group at 24 h and and 48 h after surGery were siGnificantly lower than in CIA Group( P<0. 0l). While there was no siGnificant difference amonG three Groups in term of VAS score at the 72 h after surGery. Adverse reactions of postoperative Gastrointestinal and spiritual nerve symptoms of CFNB Group were siGnificantly lower than in CEA Group and CIA Group( P<0. 0l ). Postoperative catheter related problems of CFNB Group were siGnificantly hiGher than CEA Group and CIA Group( P<0. 05 ). Conclusion AnalGesic effect of CFNB and CEA for after total knee arthroplasty is Good,and better than that of CIA. But CEA and CIA have Greater adverse reactions.

Objective To make a further understanding of the CT features of intraorbital meningioma,and to improve the level of CT diagnosis. Methods The imaging data of CT and clinical information of 17 cases with operatively and pathologically proved intraorbital meningioma(primary or secondary) from October 1997 to October 2006 in our hospital were retrospectively analysed.Results There were 11 optic nerve sheath meningiomas,4 orbital bone meningiomas and 2 sphenoid ridge meningiomas.On contrast-enhanced CT scan,most of the cases displayed an even enhancement.The "orbit sign""sleeve sign" and the hyperostosis of orbital bone were characteristic features of intraorbital meningioma.Conclusion CT examination plays an important role in diagnosing intraorbital meningioma.

ObjectiveTo study the effect of the cognition training on aphasia after stroke. Methods60 patients with aphasia and cognition functional impairment after stroke were divided into 2 groups. The control group received comprehensive treatment, including speech therapy, while the treatment group accepted cognitive functional training in addition. They were assessed with the Loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA) and China Rehabilitation Research Center Aphasia Examination (CRRCAE) before and after training. ResultsThe scores of LOTCA (P<0.05) and the CRRCAE (P<0.0001) improved in treatment group compared with the control group after training. ConclusionThe cognition functional training above the aphasia functional training facilitates the recovery of aphasia in patients with aphasia and cognition disorder after stroke.

Objective To investigate the CT manifestations of hepatocellular adenoma,and improve the CT diagnostic accuracy of the disease.Methods CT manifestations of 10 cases with hepatocellular adenoma proved by pathology were analyzed retrospectively.Results On plain CT scan,the lesions were isodensity or slight hypodensity in 10 cases,which was hardly distinguished from the normal tissue.In all 10 cases,the lesions showed marked enhancement in the arterial phase.the mean CT value of hepatocellular adenoma in the arterial phase was much higher than that in portal venous and delay phase.Conclusion CT scan is helpful for the diagnosis of hepatocellular adenoma.

Objective To evaluate the effect of different doses of aspirin on the platelet inhibition rate by thremboelastography.Methods One hundred and eighty patients with ischemic stroke or transient cerebral ischemic attack (TIA) were randomly divided into aspirin 100 mg/d group (60 patients),aspirin 200 mg/d group (60 patients) and aspirin 300 mg/d group (60 patients) according to the order of treatment.The platelet inhibition rate which arachidonic acid pathway induced was measured by thromboelastography and compared at different time points (before medication; 7 days,6 months,1 year after medication).Results There were significant differences in the platelet inhibition rate after medication at different time points compared with that before medication in three groups (P ＜ 0.05).After medication at different time points,the platelet inhibition rate of aspirin 100 mg/d group and aspirin 200 mg/d group was gradually decreasing.On the contrary,that of the aspirin 300 mg/d group showed gradually increasing.Cross-sectional comparison of the three groups at different time points showed that there was no significant difference in the platelet inhibition rate among three groups before medication,7 days,6 months after medication (P ＞ 0.05).However,there was significant difference at 1 year after medication (P ＜ 0.05).The platelet inhibition rate inaspirin 300 mg/d group [(93.8 ± 18.6)％] was higher than that in aspirin 200 mg/d group [(83.7 ± 11.2)％]and aspirin 100 mg/d group [(76.6 ± 12.8)％] (P ＜ 0.05).During medication there were 9 patients of less than 50％ platelet inhibition rate in aspirin 100 mg/d group,5 patients in aspirin 200 mg/d group,3 patients in aspirin 300 mg/d group,and 2 patients of peptic ulcer bleeding in aspirin 300 mg/d group.Conclusions The appropriate dose of aspirin (100,200,300 mg/d) can play a very good anti-platelet effect.Increasing the dose on the basis of 100 mg/d,the platelet inhibition rate shows no increase in the short-term (≤6 months),but in the long-term (1 year) there may be differences.It may be associated with less aspirin resistance and the relative increasing bleeding risk.

Objective By detecting the expression of caveolin-1 in osteosarcoma tissues,to explore its possible roles in the occurrence,progress and metastasis of osteosarcoma and its relationship with clinicopathological features.Methods The expression level of caveolin-1 protein in 48 osteosarcoma tissues and 24 normal bone tissues were detected by immunohistochemistry of SP method.Its relationship with clinical and pathological features were also analyzed.Results among the 48 osteosarcomas examined,38 were stained weak or negative for caveolin-1,whereas the strong caveolin-1 staining was observed in all the 24 normal bone tissues.The absorbent optical density value of caveolin-1 protein in osteosarcoma tissues and normal bone tissues were(0.2292 ± 0.0329) and(0.6428 ± 0.0028),respectively.The expression of caveolin-1 in osteosarcoma tissues was significantly lower than that in normal bone tissues (t =21.48,P ＜ 0.01 ).Caveolin-1 protein expression was significant correlated with the pulmonary metastasis of tumors ( t =11.84,P ＜ 0.05 ),but had no correlation with nge,sex,tumor size and pathologic grades.Conclusion The low expression of caveolin-1 may participate in osteosarcoma invasion and metastasis,and may be a new prognostic molecular marker for osteosarcoma and a new therapeutic target for tumor.

Objective To investigate the species composition and quantitative dynamic state of rodent and parasitic flea in Huairou District of Beijing City,and to carry out serologic monitoring of animal plague.Methods Rodent density was investigated at different habitats in eight villages and towns between 2009 and 2011.Serum samples from captured rodents were detected by indirect hemagglutination test,and genotypes of collected parasitic fleas were identified.Results A total of 709 rodents which belong to eight different kinds were captured with a rodent density of 2.52％ (83/3 300),and Rattus niviventer and Apodemus peninsulae were dominant species,acounted for 46.4％ (329/709) and 18.1％(128/709),respctively.Five hundred and sixty-three serum samples of rodents were tested by plague indirect hemagglutination,and all of them were plague antibody negative.Two hundred fleas were checked with a flea infected rate of 29.63％ (48/162),and a flea index of 1.23; Paraceras crispus and Leptopsylla pavlovskii were dominant flea species,a total of 30 and 27,respectively.Conclusion Some environment conditions are suitable for rodents survival,even though there is no sign of animal plague epidemic.

Objective To discuss CT,X-ray and sonographic features of atypical kidney cyst.Methods CT,X-ray and sonographic findings in 9 cases with pathologically-proved atypical kidney cyst were retrospectively analyzed.Results CT and sonography could diagnose atipical kidney cyst with a high accuracy.Of 9 cases,bloody kidney cyst 3 cases,calcified kidney cyst 2 cases,separate kidney cyst 3 cases.Renal milk of calcium kidney cyst 1 case.CT and ultrasound can display the forms and features of atypical kidney cyst.Conclusion CT and sonography are of great value for the diagnosis of atypical kidney cyst.It is difficult in differentiating the bloody kidney cyst and renal carcinoma with muddy cystic content.Ultrasound guided puncturing biopsy sould be carried out.

Objective To analyze features and diagnostic value of imageology of the early peripheral lung carcinoma.Methods The dynamic changes of early peripheral lung carcinoma confirmed pathologically in 21 cases were retrospectively analysed.The imaging features in combination with pathological data were also analysed.Results All of 21 cases,16 cases were the tubercle type(76.1%),3 cases were the spot type(14.3%) and 2 cases were the vacuole type(9.6%).Conclusion The typical imaging features of early peripheral lung carcinoma are few,the dynamic observation of the disease is of relatively high value in diagnosis.