Objective To evaluate the efficacy of video-assisted thoracoscopic surgery(VATS)for spontaneous pneumothorax.Methods From January 2003 to June 2006,VATS was carried out in 61 cases of spontaneous pneumothorax in our hospital.Resection or ligatation of pulmonary bullae,and pleurodesis were performed by using Endo-GIA.Results Among the cases,unilateral VATS was performed on 58 patients(an axillary small incision was made in one case),and bilateral VATS was done in 3.No conversion to open surgery or severe postoperative complications occurred in this series.Pulmonary bullae was detected in 56 of all the patients.The operation time was 35-55 min(mean,46 min)for unilateral VATS,and was 85,175,and 190 min respectively for the 3 cases of bilateral VATS.The mean blood loss for unilateral operation was 40 ml(range,30-45 ml),and the blood loss in the 3 cases of bilateral VATS was 55,60,and 200 ml.The thoracic-drainage volume was 230-500 ml(mean,390 ml)in the unilateral cases,and was 350,1030,and 1200 respectively in the 3 bilateral cases.The drainage tube was withdrawn 3-6 d(mean 4 d)later in the unilateral cases,and 3,4,and 5 d later in the 3 bilateral cases.The 61 patients were followed up for 4-24 mon(mean,8 mon),during which one patient experienced recurrent pneumothorax in 2 months and was cured by closed thoracic drainage.Conclusions VATS is safe and effective for patients with spontaneous pneumothorax.

Objective: To demonstrate the influence of HMGB34367,a subfamily member of the high-mobility group protein B1(HMGB1),as a transcriptional factor of the ?-SMA gene expression.Methods: We cloned HMGB34367 cDNA from the fibrotic lung tissue of the Balb/C mouse treated with BLM by RT-PCR,sub-cloned it into a eukaryotic expression vector pcDNA 3.0 or pEGF-N2,and constructed a report plasmid,pDsRed-SMA,encoding red fluorescence(RFP) driven by ?-SMA promoter.Following the co-transfection of pDsRed-SMA and HMGB34367-pcDNA3.0/ pEGF-N2-HMGB34367 in the cultured 16HBE cells,we tested the expression of the RFP in the absence and presence of TGF?1 by fluorescence microscopy.After the transfection of HMGB34367-pcDNA3.0,the nucleus extracts from the transfected cells were subjected to electrophoretic mobility shift assay(EMSA) for the detection of the binding activity of HMGB34367 with ?-SMA promoter CarGB motif.RT-PCR was performed for the evaluation of the ?-SMA gene expression in the cells.Results: The over expression of HMGB34367 activated the ?-SMA promoter and enhances the expression of the ?-SMA gene.An increased binding activity of HMGB34367 with CarGB motif was detected by EMSA in the transfected cells.Conclusion:HMGB34367,a member of HMGB1 family,could act as a transcription factor for the transcriptional activation of the ?-SMA gene,which may play an important role in the development of lung fibrosis.

Purpose:To analyze retrospectively the clinical manifestation, treatment and prognosis. Methods:From 1978 to 1996,16 patients with olfactory neuroblastoma were treated.4 cases were stage A,6 cases were stage B and 6 cases were stage C. Six patients were treated with radiotherapy alone or combined with chemotherapy, 9, with surgery and postoperative radiotherapy and 1,with operative alone. The radiation dosage ranged from 40～70Gy with 2 Gy per day. Results:The 1 , 3 and 5 year survival rates were 75%, 75% and 69%.Conclusions:Olfactory neuroblastoma is sensitivity for radiotherapy, for the patients with stage A, radiotherapy alone is effective for stage B and C olfactory neuroblastoma , combined modality of surgery and postoperative radiotherapy should be the treatment of choice.

Objective To investigate the relation of inflammation markers to acute coronary syndrome and the clinical significance by observing the changes of P selectin、CRP 、IL 6、TNF ?、ICAM 1 during unstable agina pectoris and acute myocardial infarction(AMI). Methods 45 patients were selected as acute coronery syndrome(ACS)group, including 25 patients with unstable agina pectoris (UAP) and 20 patients with AMI; 25 patients as stable agina pectoris (SAP)and 20 persons as control group. The blood sample of the control group are drawn from venous in the morning, the agina pectoris group are drown from venous in the morning of the second day after hospitalized, however, the AMIgroup are drown from venous at the point of 6 hour、 12 hour、24 hour、48 hour、72 hour after episode. The concentration of CRP is determined by Scatter Turbidimetry , and the concentration of P selectin、IL 6 、TNF ?、ICAM 1 by ELISA. Results (1) SAP vs control ,the levels of P selectin、CRP 、IL 6、TNF ?、ICAM 1 all raise significantly ( P 0.05) ; (4) AMI vs SAP , the levels of P selectin、CRP 、IL 6、TNF ?、ICAM 1 all raise significantly ( P

Objective To investigate the clinical efficacy of tegafur, gimeracil and oteracil porassium capsules combined with oxaliplatin in the treatment of patients with advanced gastric cancer and liver metastases. Methods From January 2012 to February 2017,125 patients with advanced gastric cancer and liver metastases in the Second People＇s Hospital of Jiande were selected and randomly divided into control group and observation group. The control group(63 cases) was treated with tegafur,gimeracil and oteracil porassium capsules. The observation group (62 cases) was treated with tegafur,gimeracil and oteracil porassium capsules combined with oxaliplatin. The clinical efficacy of the two groups was evaluated,and the adverse reactions during the treatment were recorded. The serum levels of matrix metalloproteinase 9 (MMP－9) and vascular endothelial growth factor (VEGF) were measured before and after treatment. Results The total effective rate of the observation group was 80. 64% (50/62),which was significantly higher than 57. 14% (36/63) of the control group (χ2=8. 294,P =0. 015). The incidence rate of adverse reaction in the observation group was 22. 58% (14/62),which was significantly lower than 47. 61% (30/63) in the control group (χ2=8. 588,P=0. 003). After treatment,the levels of MMP－9 and VEGF in the two groups were significantly lower than those before treatment (all P=0. 000). The MMP－9 and VEGF levels in the observation group were significantly lower than those in the control group(t=14. 203,1. 560,P=0. 000,0. 000). Conclusion The efficacy of tegafur, gimeracil and oteracil porassium capsules combined with oxaliplatin in the treatment of advanced gastric cancer with liver metastasis is significant and has less adverse reactions.

Objective To analyze the clinical and immunological manifestations of antiphospholipid syndrome(APS)in a cohort of 100 patients.Methods The clinical and serologic features of APS(Sapporo preliminary criteria)in 100 patients were analyzed retrospectively.Results The cohort consisted of 79 female patients and 21 male patients witb a mean age of 36?13 years at diagnosis.Primary APS was presented in 37% of patients;APS was secondary to systemic lupus erythematosus(SLE)in 46%,lupus-like syndrome in 14%. Eighty percent of the patients had thrombosis,43(54%)patients had venous thrombosis,18(22%)had arterial thrombosis,15(19%)had both arterial and venous thrombosis.4(5%)had thrombosis of microcirculation. Forty-two(52%)patients presented thrombosis at a single site,26(32%)at two sites,12(15%)at three or more sites.Forty-five(56%)patients experienced one thrombotic episode,20(25%)patients had only one re- currence,and 15(19%)had more thrombosis.The most common manifestations of thrombosis were deep vein thrombosis(36%),pulmonary embolism(30%)and stroke(26%),with heart,kidney,gastrointestinal tract and other organs involvements.Thirty-four(51%)female patients had spontaneous fetal losses including intrauter- ine fetus death and recurrent spontaneous abortion.Seventy-one(71%)patients developed thromboeytopenia. The presence of antieardiolipin antibody(ACL)was detected in 84 patients(84%).Among 90 patients with APS,alone ACL was detected in 38 patients(42%),both ACL and lupus anticoagulant(LA)were detected in 36(40%),LA alone in 16(18%).Patients with APS associated with SLE or lupus-like syndrome had higher frequency of arthritis,leukopenia,antinuclear antibodies(ANA)and low complement levels.Female patients had a higher frequency of leukopenia,ANA and ACL.Male patients had a higher prevalence of deep venous thrombosis in the lower limbs and LA.Conclusion APS is an autoimmune disorder characterized by recurrent arterial and venous thrombosis,fetal loss,or thrombocytopenia with the presence of ACL and/or LA.In APS secondary to with SLE,the patient's sex can modify the disease expression and define specific subsets of APS.

Objective:To research the efficacy and adverse reactions of compound matrine injection combined with chemotherapy in the patients with advanced gastric cancer. Methods:According to the order of admission, 68 patients with advanced gastric cancer were divided into the observation group (34 cases) and the control group (34 cases). The two groups of patients were given chemo-therapy, and the observation group was treated with compound matrine injection additionally. After 3 months treatment, the curative effect and KPS score before and after the treatment were compared between the two groups. And adverse drug reactions were recorded for the two groups. Results:The total effective rate of the observation group (44. 12%) was significantly higher than that of the control group (20. 59%,P<0. 05). After the treatment, the KPS score of the observation group was significantly higher than that of the con-trol group (P<0. 05). The incidence of adverse drug reactions in the observation group was significantly lower than that in the control group (P<0. 05). Conclusion: The curative effect of compound matrine injection combined with chemotherapy for advanced gastric cancer is notable, which can significantly improve the KPS score and reduce the incidence of adverse reactions, and is worthy of promo-ted use in clinical practice.

Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; trends

Objective To explore the application and significance of multiple clinical pathway training oriented teaching model in clinical teaching of laboratory diagnostic. Methods Totally 50 medical students enrolled in the Second Military Medical University from September to December in 2015 were divided into experimental group and control group. The course consists of theoretical teaching and experi-mental operation. The pathway group (n=25) were introduced into multiple clinical pathway training oriented teaching method. The theoretical teaching was carried out bysimulation examination application, simulation interpretation and simulation diagnosis and treatment, while the experimental course was carried out by using video teaching combined with actual operation. The control group was taught by traditional teaching method using slide teaching and operation display. The theoretical test including case study and operational skill tests were performed among students in both groups after 10 class hours training . The satisfaction questionnaires were conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. Differences were compared with independent sample t testing using GraphPad Prism 5.0 statistical software. Results The medical records about professional theoretical test including case study and opera-tional skill test in the pathway group were superior to those in the control group with significant statistical difference (both P<0.05). The records of medical students were (81.84±7.21), (42.00±2.79) in the pathway group and (76.24 ±6.98), (37.00 ±3.71) in the control group. The questionnaire result showed that the pathway group's satisfaction was high, especially with the theoretical knowledge andsceneteaching (higher than 80％). The pathway group believed that multiple clinical pathway training helped to improve learning interest and clinical thinking ability . Conclusions Multiple clinical pathway training oriented teaching model is helpful for the medical students to achieve the basic idea of clinical pathway, improve the profes-sional ability, enhance the interest of learning and the quality of teaching, standardize teaching and promote teaching and learning.

BACKGROUND: Matrix metalloproteinase (MMP) is a kind of protease family, its activity can be inhibited by tissue inhibitor of metalloproteinase (TIMP), especially by TIMP-3.OBJECTIVE: To fully isolate and purify natural TIMP-3, and to create enzyme-linked immunoassay of TIMP-3.DESIGN: Single-sample observation SETTING: Central Laboratory of Shenyang Medical College MATERIALS: Human placenta from Department of Obstetrics & Gynecology, Fengtian Hospital Affiliated to Shenyang Medical College (Informed consent was obtained from the relatives of patients) and MMP-1 from Research Institute. Fuji Chemical Industries, Ltd.METHODS: This experiment was conducted in the Central Laboratory of Shenyang Medical College between March 2001 and May 2002. Firstly,4 mol/L urea Tris-buffer solution (pH8.0) was used to prepare homogenate solution of placenta. Secondly, homogenate solution was performed chromatography through CM52 positive ion-exchange resin and Sephacryl S200 gel filtration. Thirdly, relative molecular weight and purity were detected by SDS- polyacrylamidedel gel electrophoresis (SDS-PAGE).Fourthly, Western blotting was used to identify the characters of purified protein. Fifthly, the inhibitory rate of TIMP-3 to MMP-1 was measured with immumofluorescence method.MAIN OUTCOME MEASURES: ① The relative molecular mass of protein showed by PAGE. ② Results of Western blot. ③ The inhibitory rate of TIMP-3 for MMP-1. ④ The recovery rate of TIMP-3 following purification.RESULTS: ①The isolated and purified TIMP-3 from human placenta consisted of non-glycosylated and glycosylated protein, with relative molecular mass of 24 000 and 27 000, respectively. ② The inhibitory concentration of non-glycosylated and glycosylated TIMP-3 was 1.1×1010 mol/L and 1.2×1010 mol/L respectively to MMP-1. The inhibitory concentration of placenta-derived TIMP-3 was significantly higher than that of recombinant TIMP-3 for MMP-1. ③ The recovery rate of TIMP-3 was 23.4% following two-step chromatography.CONCLUSION: Extracellular matrix of human placenta-derived TIMP-3 consists of non- glycosylated protein and glycosylated protein; Two kinds of purified TIMPs-3 have remarkable inhibitory concentration for MMP-1, and significantly higher in comparison with recombinant metalloproteinase inhibitory factor-3.