Objective To discuss the feasibility on reducing the postoperative pulmonary complications ( PPC) incidence after thoracot-omy on chronic obstructive pulmonary disease ( COPD) though application of incentive spirometry ( IS) . Methods 62 patients with COPD concurrent thoracotomy were divided into control group and observation group,the control group was given routine nebulization,expectoration and other physical treatment;the observation group were given IS besides the conventional treatment. The incidence of PPC,prognosis,and the changes on pulmonary function were compared between these two groups. Results The incidence of PPC and mortality of observation group were significantly lower than those of control group,and the inspiratory capacity( IC) from 3~5 days was significantly higher than that of con-trol group. Conclusion Application of IS can reduce the PPC incidence after thoracotomy on COPD patients,and promote the recovery of pulmonary function.

Objective To investigate the clinicopathological features ,diagnosis and differential diagnosis of primary leiomyo‐sarcoma of the thyroid gland .Methods The pathological characteristics and immunohistochemical features in a case of primary leio‐myosarcoma of the thyroid gland were analyzed and the relevant literatures were reviewed .Results Grossly ,the mass measured 5 .5 cm × 4 .0 cm × 3 .5 cm ,gray and yellow in cut surface and partial hard quality .Histologically ,the tumor was composed of spin‐dle cells ,arranging in bundles with obvious dysplasia ,nuclear mitosis was easily found .The tumor infiltrated thyroid follicles and in‐vaded surrounding tissues .The immunohistochemical study showed that Vimentin ,SMA ,Caldesmon and Actin were positive ,and CK ,CK8 ,EMA ,TTF‐1 ,P53 and LCA were negative .Conclusion Primary leiomyosarcoma of thyroid gland is extremely rare ,its diagnosis should be combined with clinical and imageologic data ,histological characteristics and immunohistochemistry .

Objective To study the influence of ammoniummeta vanadate on the histological structure of jejunum of rats. Methods One hundred and twelve healthy and clean SD rats were randomly divided into the high dosage (60 mg/L),the moderate dosage(40 mg/L),the low dosage(20 mg/L) and the control group(distilled water),28 in each group,the males and females in the same number,the administration was conducted through drinking water,for 8 consecutive weeks. In the 4th and 8th weeks,the length of jejunum villus,the depth of jejunum gland and the thickness of jejunum wall were measured,the ratio of villus length and gland depth were counted and the pathological examination was done. Results With the increase of ammoniummeta vanadate,the weight of SD rats,the jejunum villus length,the depth of the jejunum gland,the wall thickness had showed a downward trend,the ratio of villus length and gland depth were significantly lower (P

Objective To understand the effect of vanadium to liver ultramicro structure in SD rats.Methods One hundred and fifty generaMevel SD rats of 2 months were randomly divided into control groups,30 in each,the males and females were equivalent,treated with ammonium metavanadate at doses of 0,10,20,40,60 mg/L through drinking water.After 2,6 and 10 weeks of treatment,6 rats from each group were weighed and the changes of ultramicro-structure in the liver were examined with electron microscope.Results As the increasing of dose,the increase in body weight showed a downward trend,but the coefficient of liver showed a increasing trend,the consistent performance was seen in male and female rat.After two weeks of exposure,the rats acted,ate and drank less,hair roughing and no shining,often getting together were seen.After 10 weeks,the rats had not the basic activities,the hair was disheveled and loose,some died,the structure of mitochondria and endoplasmic reticulum was normal in the 10,20,40 mg/L group,the number of endoplasmic reticulum increased,in 60 mg/L group,the rough endoplasmic reticulum vanished,the liver cytoplasm had a swelling phenomenon,the mitochondria reduced.Conclusion Vanadium have little effect on the liver cells of rats in low exposure level,but high level exposure may damage the liver cells in rats.

Objective:To evaluate the effectiveness of abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian in treating chronic pharyngitis. Methods:Thirty eligible subjects with chronic pharyngitis were given abdominal acupuncture plus needling Lieque (LU 7) and Zhaohai (KI 6), two out of the Confluent Points of the Eight Extraordinary Meridian, once a day, 10 sessions as a course, and the therapeutic efficacy was evaluated after a treatment course. Results:After a treatment course, of the 30 subjects, 21 were recovered, 5 showed markedly effective, 2 were improved, and 2 failed,the total effective rate was 93.3%. Conclusion:Abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian is effective in treating chronic pharyngitis, worth promoting in clinic.

Adult ; Aged ; Female ; Humans ; Infratentorial Neoplasms ; diagnosis ; surgery ; Male ; Meningioma ; diagnosis ; surgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Supratentorial Neoplasms ; diagnosis ; surgery ; Treatment Outcome ; Young Adult

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.

Objective To evaluate the prognostic value of lateral lymphadenectomy for advanced lower rectal cancer. Methods A total of 96 consecutive patients who underwent total mesorectal excision and lateral lymphadenectomy for advanced lower rectal cancer were retrospectively evaluated by using therapeutic index. A product of the frequency of lymph node metastasis and the cancer-related 5-year survival rate. Results The incidences of lymph node metastasis in mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 21%,13%.10%and 15%respectively.The 5-year survival rate of patients with metastasis to the mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 35%,25%,20%and 36%respectively.The therapeutic indexes for total mesorectal excision and lateral lymphadenectomy were 7.4 and 5.4,which were much higher than that of lymphadenectomy of the superior rectal artery area(3.3)and inferior mesenteric artery area(2.0).Local recurrence occurred in 19%(18 out of 96 cases)patients with advanced lower rectal cancer. Local recurrence rate of patients with positive lateral lymph node metastasis was 64%(9 of 14 cases),whereas it was 11%(9 of 82 cases)in those without lateral lymph node metastasis. The difference between these two groups was statistically significant(x2=22.308,P=0.000).Kaplan-Meier survival analysis showed significant improvements in median survival(80.9±2.1)m,95%CI:76.7～85.1 m vs(38±6.7)m,(95%CI:24.8～51.2 m)for patients with negative lateral lymph node metastasis over patients with lateral lymph node metastasis(log-rank,P=0.000). Conclusion The current results indicate that lateral pelvic lymphadenectomy could significantly reduce loeal recurrence and effectively improve the survival of patients with advanced lower rectal cancer. Except for total mesorectal excision, lateral pelvic lymphadenectomy should be followed in the surgery of pailents with advanced low rectal cancer.

Objective To explore the effect of high-fat diet(HFD) on redox states of duodenum and calcium absorption in mice,and to analyze the relation between them.Method Fifty C57BL/6 male mice were randomly assigned to five groups.The control group consumed an ordinary diet(0.6% Ca,w/w),and other four groups were fed with HFD(19.64%lard,0.6% Ca),HFD plus 0.1% lipoid acid(LA),HFD with calcium supplement(1.6%Ca) and HFD with 1.6% Ca and 0.1% LA supplement.Calcium apparent absorption was measured by mineral balance study after feeding for 8 w.Plasma and duodenum levels of ROS,SOD,CAT,MDA,GSH/GSSG,and T-AOC were measured to evaluate the antioxidant status.Results HFD induced oxidative stress of duodenum and decrease of intestinal calcium absorption in mice.There were positive correlations between calcium apparent absorption with GSH/GSSG(r=0.801,P

Objective To investigate the changes in femoral gene expression profiles in C57BL/6 mice fed high-fat diet (HFD) via clustering analysis of DNA microarray.Method Sixteen male C57BL/6 mice (4w old) were randomly assigned to two groups,8 in each,after 4-d ordinary diet for adaptation.The control group was fed with an ordinary diet,and the HFD group with HFD(19.5% lard).All mice were sacrificed at the end of 12w and the femoral gene expression was detected by oligonucleotide microarray analysis with Affymetrix Gene Chip Mouse U430A.DAVID,an online tool,was used for clustering analysis on femoral gene expression.Results Longtime administration of HFD caused femoral gene expressed differences related to cation ion channel,transcription regulation and signal transduction,bone mineralization,phosphate metabolic process regulation,and collagen synthesis.Conclusion Longtime intake of HFD will change the expression of numerous bone metabolism-related genes in bone of mice,and then inhibit bone formation.