To discuss the relationship between suspend particles in the air and respiratory diseases. After the fine particle in the air inhaled into the lung, they retained mainly alveolar ducts and alveoli. They induced inflammatory reactive process and produced inflammatory cytokines in the respiratory tract and epithelial hyperplasia, increased the morbidity of respiratory diseases. The polycyclic aromatic hydrocarbons (PAHs) in the air pollutants had carcinogenesis, the mucosa was irritated by it for long-term and might result in canceration and it increased morbidity and mortality of lung cancer.

Objective To study the feasibility and efficacy of minimally invasive repair for pectus excavatum in adult patients. Methods A total of 23 patients with pectus excavatum aged 18-38 years(mean 24.1?6.6) were treated in our hospital from June 2006 to June 2008.On admission,21 of patients had never been treated,and 2 patients were recurrent cases after Ravitch surgery;the Haller index of the cases ranged from 3.2 to 7.5(mean 4.38?1.16);type I pectus excavatum was diagnosed in 14 of the patients(60.9%) and type II in the other 9(39.1%).Under general anaesthesia with the patients at supine position,two 3-cm incisions were made along the bilateral mid-axillary line at the level of the most pronounced sternal depression.Then,a conductor was penetrated into the mediastinum from the right to the left at almost the same level.After establishing artificial pneumothorax by CO2 gas,a pectus bar(Lorenz) was placed through the mediastinum under the guidance of thoracoscopy.Afterwards,a stabilizer was used to fix the bar at the right side.Both the stabilizer and the bar were fixed to the muscle layer.Chest X-ray was performed to observe the stabilizer and the bar after the operation. Results Among the cases,the procedure was successfully completed in 22 patients.In the other patient,the pericardium and the right atrial appendage were injured,and we had to enlarge the incision for haemostasis.All of the patients were uneventful after the operation.No incisional infection or bar displacement occurred during the perioperative period.During a mean of 16-month follow-up(range 3-24 months),the symptom of chest distress was significant improved,and the cosmetic results were satisfying in 87% of the patients(20/23).Conclusions Minimally invasive repair is feasible and effective for adult patients with pectus excavatum.

Objective To investigate value and effect of the bronchus was cut out and bronchoplasty for lung cancer. Methods Twenty-one patients with lung cancer which all invased out one bronchial orifice and precluded standard lobectomy. The present of endobronchial tumor was cut out according to the lesion region during operation, the bronchoplasty performed by health bronchial wall. Results There were squamous carcinoma in 15 patients; adenocarcinoma in 4; small cell lung cancer and carcinoid each one patient. Staging: stage Ⅰ in 3 patients; stage Ⅱ in 12, stage Ⅲa in 6. The 19 patients were uneventful after operation. The 2 cases died from acute pulmonary embolism or gastric irritable ulcer with large bleeding in perioperation. Respiratory failure in all patients had not occurred. Bronchoscopy performed immediately after operation in 16 patients and in the period of following up 6-36 months in 12 patients, the mucosa of bronchoplastic sites was smooth, no bronchial stenosis and no tumoral relapse.The period of following-up was 4-72 months, median survival 42 months after operation. Five patients died from the metastases or relapse. Life time in survival patients was well. Conclusion The bronchial resection by cut out and bronchoplasty for lung cancer had a good results in near future and long period, and proved individualized and adapted selective type of resection for bronchoplasty of lung cancer.

Objective To summarize the experiences in clinical diagnosis and surgical treatment of chest cancers invading the superior vena cava (SVC). Method Retrospective study of 12 cases with chest cancers invading the SVC, SVC and innominate vein were reconstructed with prosthesis in 3 cases, the side wall of the SVC was excised and repaired in 9 cases. Results Complete resection was performed in 10cases,2 cases had incomplete resection. There was no death associated with operation in these patients. All patients were followed up for 1 - 7 years after operation,and 3 cases were lost to follow up,5 of remaining 9cases were dead because of relapse and metastasis, their median survival time was 8 months,other 4 cases lived, their median survival time was 42 months. Conclusions Patients with chest cancers invading the SVC should have surgical treatment of not only tumor resection but also the vessel reconstruction,the prognosis would be better than without surgical treatment. These patients have a high quality of life and live with long-term survival.

Objective To access the alterations of ischemic myocardial regional motion time caused by different extent of coronary artery stenosis by 2D-strain technique. Methods Two-dimensional images were acquired of the standard parasternal and apical (4-chamber,2-chamber and long-axis) views and short-axis views (mitral annulus, papillary muscle and apex) in 140 patients with coronary artery disease. All left ventricular segments were divided into 5 groups according to coronary stenosis seen on angiography:normal,25% -49% ,50% -74% ,75% -99% and 100%. The time to segmental systolic peak strain, systolic peak strain rate, end systolic strain, early diastolic peak strain rate and late diastolic peak strain rate in longitudinal, radial, circumferential directions and the systolic peak rotation, systolic peak rotation rate, early diastolic rotation rate,late diastolic rotation rate were analyzed with EchoPAC offline software. Results In longitudinal direction,compared with normal group,the time to early diastolic peak strain rate of segments with 75% - 99% coronary stenosis increased significantly, the time to systolic peak strain rate, early diastolic peak strain rate of segments with occluded artery were significantly delayed compared with the other 4 groups (P ＜0.05). In radial, circumferential directions, the time to systolic peak strain, systolic peak strain rate,late diastolic peak strain rate of segments with 25% - 49% was shorter than that of normal segments. Those indices for segments with 50% - 74% coronary stenosis were delayed compared with segments with 25% - 49% stenosis, however, those for segments with 75% - 99% coronary stenosis showed some improvement in the comparison with segments with 50% - 74% stenosis. All time indices for segments with occluded arteries were delayed ( P ＜0.05). About rotation, the time to the systolic peak rotation,systolic peak rotation rate,early diastolic peak rotation rate with 25% -49% stenosis was shorter than those of normal segments, the time to systolic peak rotation and early diastolic peak rotation rate for segments with 75% - 99% stenosis improved compared with segments with 50% - 74% stenosis.Conclusions 25% -49% coronary stenosis could lead to alterations of peak myocardial systole and diastole motion time in radial,circumferential and rotation directions,and ≥75% coronary stenosis caused the all 4 directions motion delays. Also the time indices for segments with 75% - 99% coronary stenosis showed some improvement in the comparison with segments with 50% -74% coronary stenosis.

Objective To study the protective effects of the coronary collateral circulation to ischemic myocardial regional function with coronary artery stenosis≥75%using 2D-strain technique.Methods Two-dimensional images of apical four-,two-chambers,long-axis views and LV short-axis views were obtained in 121 patients.According to the results of coronary angiogram,all the 121 patients were divided into 3 groups:group 1,with normal coronary artery;group 2,with stenosis≥75%in≥1 main coronary artery involved right coronary artery,left anterior descending branch and left circumflex branch and with the presence of coronary collateral circulation(CCC);group 3,with stenosis≥75% in≥1 main coronary artery but with no presence of CCC.The segments' systolic peak strain(Sps),strain rate (SRs),end systolic strain (Yes),early diastolic strain rate (SRe) and late diastolic strain rate (SRa) in longitudinal (L),radial (R),circumficial (C) directions and the rotation (Rot),rotation rate were analyzed with EchoPAC offline software.Results Compared with 1 group,LSps,LSes,LSRs,LSRa,RSRe,RSRa,CSRe,Rotsre,Rotsra of 2 group,LSps,LSes,LSRs,LSRa,LSRe,RSes,RSRs,RSRe,RSRa,CSps,CSes,CSRs,CSRe,CSRs,Rotps,Rotsrs,Rotsre,Rotsra of 3 group decreased significantly (P＜0.05) ;compared with 2 group,LSps,LSes,LSRs,RSes,RSRs,CSps,CSes,CSRs,CSRa,Rotps,Rotsrs,Rotsre of 3 group decreased markedly (P＜0.05).Conclusions Coronary collateral circulation provides a protection effection to ischemic myocardial regional function.2D-strain technique may serve as an efficient method to assess ischemic myocardial regional function.

Objective To explore the effects of Levoeitirize dihydrochloride on interleukin-13(IL-13)and interleukin-18(IL-18)in the serum of the patients with cough variant asthma(CVA).Methods 70 cases with CVA were randomly devided into control group of 35 cases and treatment group of 35 cases.Control group was given Chlort rimeton and the treatment group was given Levocitirize dihydroehloride.The levels of IL-13 and IL-18 in the serum were measured before and after treatment.Results After treatment,the concentrations of IL-13 and IL-18 in patients in the treatment group were(46.7±17.3)ng/L and(145.2±27.1)ng/L，and those in the control group were(98.5±30.7)ng/L and(179.6±30.5)ne/L，which were significantly improved.Conclusion The treatmem of Levoeitirize dihydrochloride could improve the CVA through improving the production of IL-13 and IL-18.

BACKGROUND: Studies on the biomechanical properties in NUSS procedure have obtained some achievements, but the effect of scoliosis surgical correction of scoliosis on thoracic deformity remains unclear.OBJECTIVE: To explore the effect of simultaneous correction of pectus excavatum and scoliosis on thoracic deformity so as to provide reference for designing a rational orthopedic scheme.METHODS: The three-dimensional reconstruction model of the chest was established based on the CT data of the patients with pectus excavatum and scoliosis. The surgical correction of pectus excavatum and scoliosis was simulated by numerical simulation method.RESULTS AND CONCLUSION: (1) Results after correction showed that the bilateral spinous processes at T3-5 segments displaced to the left (X direction) about 1 mm, suggesting that the simultaneous correction is favorable for the correction of scoliosis. (2) Compared with the single NUSS procedure, the displacement at Y direction was increased by 13.358 mm in the simultaneous correction; meanwhile, there was significant difference in the shortest displacement between two methods.(3) In views of Von Mises stress distribution, the stress in the simultaneous correction was decreased by 24.6 MPa compared with the single Nuss procedure, indicating that the simultaneous correction can significantly reduce the Von Mises stress on the chest, which contributes to alleviate the postoperative pain. (4) Our results show that the simultaneous correction cannot only improve scoliosis, but also improve the symptoms of pectus excavatum.

BACKGROUND:It is reported that tailless-like protein (TLX) plays critical roles in the regulation of early developmental processes in vertebrates, and it plays a key role in stem cells proliferation and differentiation into neurons. OBJECTIVE: To construct recombinant plasmid pEGFPN1-TLX and study the transfection into dermal multipotential stem cells. DESIGN, TIME AND SETTING: Cytogene experiment was performed at the Department of Pathogen Biology, School of Basic Medical Science, the Third Military Medical University of Chinese PLA from March to December 2007. MATERIALS: An adult SD was obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA; dermal moltipotential stem cells (DMSCs) were cultured by the Institute of Combined Injury of the Third Military Medical University of Chinese PLA; pEGFPN1 and DH5α was gifted by professor Xu.METHODS: Total RNA was extracted from rat brain tissue to amplify TLX-coded cDNA sequence using RT-PCR. T/A was cloned on pMD18-T vector and determined using BamHI and Hindlll. The products were positive recombinant plasmid pMD18-T-TLX segments, which were sub-cloned in pEGFPN1 to construct recombinant plasmid pEGFPN1-TLX. Finally, pEGFPN1-TLX was transfected into DMSCs.MAIN OUTCOME MEASURES: The fluorescence protein expression was observed under fluorescence microscope at 24 hours after transfection; TLX mRNA expression was detected using RT-PCR; neuronal differentiation was observed using immunohistochemical staining.RESULTS: TLX full length cDNA was successfully cloned into pEGFPN1, and pEGFPN1-TLX was successfully constructed by means of sequence analysis and enzyme cutting identification. As compared with non-transfected DMSCs, pEGFPN1-TLX transfected DMSCs were observed after 10 days, formed resistant clones after 15 days, and shown a green fluorescent protein expression. However, non-transfected DMSCs died at day 10. RT-PCR indicated that pEGFPN1-TLX transfected DMSCs could express TLX mRNA. At day 3 after induction, NF200 positive cells were increased, but glial fibrillary acidic protein positive cells were decreased after induction of pEGFPN1-TLX transfected DMSCs.CONCLUSION: TLX was successfully constructed and transfected into DMSCs. After transfection, neuronal differentiation of DMSCs was enhanced, and the differentiation to gliocytes was inhibited.

Objective To study thoracic re-remodeling and therapeutic effect after the bar removal for pectus excavatum corrected by minimal-invasive technique.Methods 145 cases with pectus excavatum,male 115,femal 30;adults in 59,children 86;corrected by minimal-invasive technique improved and performed by the same group surgeon.Bar removed 12-82 months after the procedure,appraising index of curative effects include in chest appearance,thoracic index,thoracic computer tomography(CT) and the distance between the behind of sternum to the anterior border of thoracic spine in the sagittal view.Results The chest shape was good.Thoracic index:before bar removal 2.36 ± 0.32 in children,2.60 ± 0.45 in adults;after that,2.77 ± 0.44 in children,3.04 ± 0.56 in adults.There was all subsidence on the each point of the sternum,descent the maximum at the inferior end of the midsternum,(15.18 ±7.95)mm in children,(14.93 ± 8.81) mm in adults,comparing with bar removal before and after.There was statistical significance.Not the signs of compressing the heart on the CT view.The time interval of the bar removed 3-year in children,5-year in adults without affecting the development of the patients' thorax.Conclusion The sternum descended slightly after bar removal when pectus excavatum corrected to expecting effects.After that,thoracic remodeling again,the chest shape well.