Objective To observe the short-term efficacy of treating the tumorous airway obstruction by placing net stents following high-frequency electrocautery via fiberoptic bronchoscope.Methods 14 patients of lung cancer with airway obstruction had undergone the tumor burning excision by high-frequency electrocautery via fiberoptic bronchoscope and placed net stents , then to observe the clinical efficiency.Results 14 patients of lung cancer with airway obstruction all revealed better efficacies, obviously improving Karnofsky scores and pulmonary function, and no evident complication was found.Conclusion Placing net stents following high-frequency electrocautery via fiberoptic bronchoscope can cure efficiently the tumorous airway obstruction, and have popular value.

AIM: To observe the effect of angiotensinⅡ subtype 2 receptor (AT_2 receptor) on the cultured rat aortic vascular smooth muscle cells. METHODS: The plasmid contained the cDNA of AT_2 receptor was transfected into cultured rat vascular smooth muscle cells. The effects of AngⅡ, Ang Ⅱ+losartan, Ang Ⅱ+PD123319 on the expression of PCNA, the NOS activity and the cell number were observed. RESULTS: The cell number and the expression of PCNA decreased after the cells were treated with losartan. When treated with PD123319, the cell number and the expression of PCNA increased, but the expression of NOS decreased. CONCLUSIONS: These data suggest that when being activated, AT_2 receptor inhibits the proliferation of vascular smooth muscle cells and antagonizes the effect of AT_1 receptor, such an effect may be related to the activation of NOS. [

Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

Objective To explore the real ear to coupler difference (RECD) changes in children with hearing aids .Methods 132 severe to profound hearing impaired children who came to hearing center for hearing aids exami-nation and adjustment were recruited into the study .They were put into 6 groups according to the test age ,<1 yr group(15 cases) ,1 yrs group(26 cases) ,2 yrs group(36 cases) ,3 yrs group(29 cases) and 4 yrs group(26 cases) . And all of them had the RECD tests for both ears with custom earmolds .Results The average RECDs for both ears decreased with the age increased .There were statistically differences for the same lateral ears when age differences surpass 2 years except for the difference for left ears between the children in the <1 yr group and 2 yrs group .This study showed there were statistically differences between left and right ears for majority of groups (except for 2 yrs group) .Conclusion RECD is an important factor for individual adjustment .The current results show that the chil-dren with hearing aids should have RECD tests for both ears at least once per two years .

Objective To discuss the advantages and disadvantages of the mammography and ultrasound examination for breast cancer diagnosis.Methods Totally 84 breast cancer patients enrolled in our study.All of the patients underwent mammography before surgery,and 69 of them received both mammography and ultrasound examination.The data were studied retrospectively.Results 84 foci were found totally on mammography and were all diagnosed above ACR BIRAD grade 4 by X-ray.Two of the 13 cases smaller than 2 cm in diameter were diagnosed as grade 3 by ultrasound.Eleven cases with microcalcification were diagnosed as grade 2（1case）and 3（1case）by ultrasound.Only 1 of the 6 cases shown as distortion was diagnosed as 5 by ultrasound.Conclusion X-ray has the superiority to ultrasound for distortion and microcalcification.For the mass smaller than 2 cm in diameter,both of X-ray and ultrasound may underestimate.

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.

Background Trans-scleral fixation of intraoculalen(IOL) hamade greaprogress,buthe long-term stability of the implanposition of IOL aftesurgery inoideal.Objective Thistudy wato investigate the relevanfactorof IOL dislocation aftetrans-scleral fixation of IOL.Methodrespective case-observational study wadesigned.The clinical datfrom 321 eyeof 321 patientwho had received trans-scleral fixation of IOL were collected.total of 263 patientcompleted the effeetive follow-up,and 164 patientwith the follow-up fomore than 5 years.No IOL dislocation occurred within 5 yearin all 263 eyes.The relationship between IOL material,IOL implantation location,the time of IOL dislocation and the intraoculapressure with IOL dislocation were analyzed.ResultIOL dislocation appeared 7-10 yearaftesurgery in 9 eyewith an incidence rate of 5.49％.Breakage of IOL suture wafound in all the eyewith IOL dislocation.Dislocation wamore frequently found in IOL performed in the oblique position than thain the horizontal position (10.0％ vs.3.5％).The rate of IOL dislocation wahighesin traumatiretinal detachmeneyes,apercentage of 33.33％.Single piece IOL wamore easily dislocated.ConclusionThe breakage of anchosuturein IOL ileading cause of IOL dislocation aftetrans-scleral fixation of intraoculalens,which may be associated with the weighresulting from the fixation procesin non-level angulaIOL.Iirecommended thaIOL should be fixed in the horizontal position.

Objective To evaluate the arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib for the removal of complex staghorn renal calculi.Methods Arc renal parenchyma incision of pelvis within renal sinus and renal posterior lib was performed to remove stones in 86 cases (97 sides) with complex staghorn renal calculi.Among the 86 cases,42 had stones on the right side;33,on the left side;11,on bilateral sides.Seventeen cases had concomitantly calculi in the ureter,and 54 had calculi in upper and mid calyx or multiple renal calculi.As for comorbidity,11 cases had hypertensions;4,diabetes; and 5,hepatitis B.Twenty-five cases had renal insufficiency,with BUN of 12.3 -76.0mmol/L and Cr of 231 -1721?mol/L.The procedure was performed as follows:the kidney was dissected free and the pelvis within renal sinus was isolated.Two rows of bottom style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower through the middle major calyx to the plane of upper major calyx.The renal parenchyma and mid-low calyx along the incision were opened,suturing while incising,so that all the stones could be easily removed with hook.Results The calculi were completely removed in all 86 cases (97 sides).The opera- tive time was 105-187min ( mean,129min).The intraoperative blood loss was 120-460 ml ( mean,220 ml).Forty-three cases needed intraoperative blood transfusion of 120 -200 ml (mean,140 ml).One month after operation,KUB+IVU and ultrasonic findings were normal with improved hydronephrosis,no intrarenal stricture and no residual calculi.Conclusions This procedure has the advantages of less bleeding,slight impairment of renal function,simple handling,clear operative field,high clearance rate,therefore is indica- ted for the removal of complex staghorn calculi.

Objective To explore the reasons and the best treatment options of facial mass complicated after exogenous growth factor injections.Methods 17 cases of postoperative complications caused by exogenous growth factor injections were retrospectively analyzed.15 patients with chin masses received mass resection and repairment with submental fat and fascial flap.Facial masses of the other 2 patients were located in cheek.Simple cheek mass resection was usually useful.All the patients had scar treatment.The postoperative satisfactory survey was investigated after 6 months.Results The incisions of 17 patients were healed well.An analysis through color Doppler ultrasound examination showed no residual or recurrent mass within half a year follow-up.One of the 17 patients had facial asymmetry and needed further treatment.Others were satisfied with the facial appearance of treatment.Conclusions The masses resulted from injection of exogenous growth factor should be cut off timely and reasonable reconstruction through fat and fascial flap and scar treatment are helpful to restore the original appearance of patients.

Objective To explore the experience of emergency operation for patent ductus arteriosus (PDA) in neonates and to assess the therapeutic effect.Methods The clinical data of 31 PDA neonates(15 male,16 female) treated in our department from July 2012 to February 2015 were reviewed retrospectively.Of these cases,28 were preterm infants and 3 were full term infants.Mean gestational age was 30+4 weeks ranging from 26+2 to 39 +3 weeks.Mean birth weight and weight at operation was(1 159.0 ± 729.2) g and (1 522.0 ± 644.5) g,respectively.We operated with left transaxillary straight incision in 6 cases and posterolateral minimal incision in 25 cases,and the pleural cavity was entered via the 4th intercostal space.All the neonates were divided into ＜ 1 500 g group(n =24) and ＞ 1 500 g group(n =7) by weight,the clinical prognosis were analysized.Results All 31 operations were finished successfully.No deaths occurred as a result of surgery.Average time of operation was (62.7 ± 29.9) min.Mean time of mchanical ventilation after the operation among survivors was (5.5 ± 4.7) d.The time of mechanical ventilation between ＜ 1 500 g group and ＞ 1 500 g group were (7.2 ± 2.3) d and (4.9 ± 2.4) d respectively,and there was significant difference between two groups(P ＜ 0.001).The time of hospital stay were (45.3 ± 11.0) d and (20.4 ± 14.5) d respectively between two groups (P ＞ 0.05).Twenty-eight cases recovered and released from the hospital successfully.Two cases quited the treatment themselves and 1 succumbed to death because of heart failure,hyperkalemia and arrhythmia.ConclusionEmergency surgical closure is a safe and effective method for the treatment of neonatal large PDA,especially with congestive heart failure,a variety of complications,long time ventilator dependence,medical treatment failure,which should be ligatured timely as it can have severe influence on the cardiopulmonary function.After ligation the abnormal shunt will disappear and the cardiopulmonary function will be better.It is helpful to extubate ventilators and improve the survival rates.