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.

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

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.

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 .

Chemical Industry ; Humans ; Occupational Exposure ; Risk Assessment

Objective To establish mouse allergic asthma model and observe the effect of bacterial lysates (OM-85BV) on airway inlfammation. Methods Forty-eight 4 to 6 weeks healthy male BALB/c mice were used as research subjects and randomly divided into six groups, a:control group;b:OM-85BV contral group;c:allergic asthma model;d:dexamethasone group (Dex group);e:OM-85BV A group;f:OM-85BV B group (the intervention time was prolonged 10 days than group e). BALB/c mice were sensitized and challenged with ovalbumin (OVA). Mice in groups c, d, e and f were intraperitoneally administered with antigen (OVA)-Al(OH)3 on days 1, 8 and 15, others were administered by PBS. From the 17th day to the 26th day, Mice in group f were treated with OM-85BV and others were treated with normal saline. In the next days, mice in groups c, d, e and f were intranasal given OVA for 5 consecutive days. Additionally, mice in groups b, e and f were treated with OM-85BV before challenge, while mice in the group d were administered by Dex, others were treated with normal saline at the same dose. Twenty four hours after the last intranasal administration, mice were anesthetized and dissected. Lungs were lavaged with PBS and bronchoalveolar lavage lfuid (BALF) was obtained. The total inlfammatory cells and eosinophils in BALF were counted. The total IgE levels of blood serum and IFN-γ/IL-4 levels of lavage were detected. The removed parts of lung tissue were collected for histological examination. Results Compared with groups a and b, lung tissue biopsies by HE staining from the asthma group showed obvious airway inlfammation. The situation of groups d and f was signiifcantly improved than group c, while the differences between groups e and c were not evident. Total cells and the number of eosinophils in BALF of group c (90.3±13.94×104/ml) were signiifcantly higher than that in groups a and b. Compared with the control group, levels of IL-4 in BALF (119.03±19.92 pg/ml) and IgE in serum (15.86±1.97 ng/ml) increased and levels of IFN-γin BALF (90.50±13.51 pg/ml) reduced signiifcantly. The corresponding levels of groups d, e and f were signiifcantly improved than group c (P<0.01). Conclusions Administered by OM-85BV helps regulate the balance between Th1/Th2 in asthmatic mice, reduce airway inlfammation, and prevent the occurrence and development of airway inlfammation.

Background Retinal neovascularization is associated with various disorders.Studying the pathogenesis of retinal neovascularization is of important significance.Oxygen-induced retinopathy(OIR) mouse model is a common animal model for the study of retinal neovascular diseases.However, conventional modeling methods usually cause high animal mortality and low rate of success.Objective This study aimed to establish a modified method of mouse OIR model.Methods Eighty 1-week-old SPF C57BL/6J mice were randomly divided into normal control group and OIR group with 40 mice for each.The newborn mice of the normal control group were kept in a normal air environment with their breast-feeding mothers, but the mice of postnatal 2 days (P2) in the OIR group were raised with two litters per cage until P7.The P7 mice exposed to oxygen tank containing 80％ oxygen together with one or another mother mouse alternately daily for 5 days and then returned to the normal air environment.The success rate of modeling,mortality rate of maternal mice and survival rate of immature mice were evaluated.The mixed solution of fluorescein isothiocyanate (FITC) and PBS with 4％ paraformaldehyde was infused into the hearts of P12, P14,P17 and P21 mice and the eyeballs were obtained after the mice were sacrificed for histopathological examination of retinas and preparation of retinal flatmounts.The number of vascular endothelial cells extending inner limiting membrane was counted and the distribution of retinal vessels was evaluated.The use and care of the animals complied with the Statement of ARVO.Results The survival rate of the neonatal mice was 100％ both in the normal control group and the OIR group,and the survival rate of maternal mice was 85.7％ in the OIR group.Retinal new vessels were found in the mice of the OIR group,with the success rate of modeling 100％.The retinal vessels distributed from optical disc toward periphery in P14 mice in the normal group.However,in the OIR group,non-perfusion area at the posterior pole was seen in P12 mice,new blood vessels at the periphery were found in P14 mice, neovascularization at the junction area between vascular area and non-perfusion area as well as leakages were exhibited in P17 mice,and less non-perfusion area and new vessels were seen in P21 mice.Retinal inner limiting membrane was smooth in the mice of the normal group, and the vascular endothelial cell nucleus extending inner limiting membrane were seen in P12 mice and peaked in P17 mice.The vascular endothelial cell nucleus were (11.44±2.01), (31.24±1.50) and (9.23-±1.12)/slide in P14, P17 and P21 mice in the OIR group,which were significantly more than (0.27±0.14) , (0.30±0.11) and (0.32±0.16)/slide in P14, P17 and P21 mice in the normal group (t=47.90,61.30,40.70,all at P＜0.05).Conclusions The method of OIR modeling is modified by alternating maternal mice,exposing to 80％ oxygen-nitrogen mixture gas and cohabitating immature mice.Modified modeling method is simple with the low death rate of maternal mice and stable OIR phenotype.

Objective To compare the analgesic and side effects of tramadol, buprenorphine and morphine in equipotent dosage in patient-controlled intravenous analgesia (PCIA). Methods 53 patients (ASA I-II) scheduled for upper abdominal surgery were randomly allocated to receive 10mg/ml tramadol (group T) or 0.03mg/ml buprenorphine (group B) or 1mg/ml morphine (group M) plus 0.1mg/ml droperidol. Baxter APII PCA pump was used to administer the different analgesic according to the model of LCP, with the amount of loading dose, continuous infusion and bolus of 2.5ml, 0.5ml/h, 1ml respectively. At 4, 8, 16 and 24h postoperatively, pain scores in VAS, comfort scale in BCS, sedation scores with Ramsay score, and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. Drug consumption in the first 24h and the D/D ratio (demand/deliver) were also recorded. Results VAS and BCS scores showed no significant difference among the 3 groups, but drug consumption within the first 24h and the D/D ratio in group T were higher than those in other 2 groups (P0.05). 8 patients in group T, 5 in group B and 4 in group M suffered from nausea; 1 patient in group T, 2 in group B and 3 in group M complained of pruritus. No respiratory depression was observed in all cases. Conclusion Tramadol and buprenorphine can be safely used as PCIA in patients undergoing upper abdominal surgery, but they are not superior to morphine.

Purpose To investigate renal cortical blood perfusion in patients with nephrotic syndrome (NS) by region of interest (ROI) quantification.Materials and Methods Twenty-one patients with NS treated at Wuhan Union Hospital from September 2014 to January 2015 (NS group) and twenty-nine matched healthy subjects (control group) were enrolled in our study.High frequency blood flow dynamic images of the left kidney for all the subjects were acquired by color Doppler (Philips iU22).Resistance index (RI) of interlobar artery,arcuate artery and interlobular artery were measured.Vascularization index (VI),flow index (FI),vascularization flow index (VFI) were further analyzed by ROI quantification at Q-LAB work station.Results ① The signals of renal cortical blood flow in NS patients were sparse and slim;while the signals in the control group were continuous,most of which reached the edge of renal cortical.② No statistical differences of RI values of interlobar artery and interlobular artery were found between the two groups (P＞0.05);③ The renal cortical blood perfusion in the NS patients decreased significantly compared with that in control group,and the renal cortical VI,FI and VFI values in NS group were significantly lower (P＜0.01).④ Bland-Altman analysis showed that there was good repeatability in the measurement of renal cortical VI,FI and VFI.Conclusion Color Doppler flow imaging combined with RO1 quantitative technique can assess renal cortical blood perfusion accurately,which provides diagnostic information for early detection of renal damage.