OBJECTIVE:To observe the efficacy and safety of oxaliplatin combined with thymosin in the treatment of lung can-cer with malignant pleural effusion. METHODS:120 lung cancer patients with malignant pleural effusion were randomly divided in-to control group(60 cases)and observation group(60 cases). All patients received chest microtubules drainage,then thoracic cavi-ty drug infusion after clean effusion drainage verified by B ultrasound,10 mg Loratadine tablet was orally given before going to bed 1 d before drug infusion,for 1 week;25 mg Promethazine hydrochloride injection was intramuscularly injected 30 min before drug infusion for allergy prevention,20 mg metoclopramide for gastrointestinal reaction prevention,10 mg dexamethasone and 10 ml 2% lidocaine,adding into 10 ml 0.9%Sodium chloride solution,injected to thoracic cavity by drainage tube to prevent and re-lief chest pain,fever,and other pleural reaction symptoms. Based on it,control group was injected 100 mg/m2 Oxaliplatin for injec-tion to thoracic cavity by drainage tube. Observation group was additionally given 300 mg Thymosin injection,to thoracic cavity by drainage tube. Pleural effusion was drained after 2 d. Once every week in 2 groups,4-week was regarded as 1 coure,and it lasted 2 courses. Clinical efficacy,clinical benefit rate,and serum T lymphocyte subsets(CD3+,CD4+,CD8+),inflammatory cytokines lev-els [interleukin(IL)-6,tumor necrosis factor(TNF)-α)] before and after treatment in 2 groups were observed,survival status and the incidence of toxicity reactions were followed-up. RESULTS:The objective response rate,disease control rate,clinical benefit rate,survival rate in observation group were significantly higher than control group,the incidence of toxicity reactions was signifi-cantly lower than control group,the differences were statistically significant(P<0.05). After treatment,CD3+,CD4+,CD8+ levels in observation group were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in CD3+,CD4+,CD8+ levels before and after treatment in 2 groups(P>0.05). CONCLUSIONS:Oxaliplatin combined with thymosin can improve efficacy in the treatment of lung cancer with malignant pleural effusion,prolong survival period,improve survival quality and reduce the incidence of toxicity reactions.

Objective To investigate the clinical features of hidden horizontal tears of the posterior horn of the medial meniscus and clinical efficacy of arthroscopic partical meniscectomy. Methods A total of 14 cases of hidden horizontal tears of posterior horn of the medial meniscus from May 2011 to May 2013 were enrolled.The knee arthroscopy was carried out through anteromedial and anterolateral approaches.The lesion of tears was exposed after the inner edge of posterior horn of the meniscus was bitten away.The bottom of the posterior horn of meniscus was found instable during the operation, which was then removed to conduct a partial meniscectomy.Afterwards the arthroscopic meniscus plasty of the posterior horn was performed. Results Arthroscopic photographs showed normal appearance in 6 cases and tears underside meniscus in 8 cases, all of which were confirmed to be horizontal medial meniscus posterior horn tear during operation.The mean time of operation was 32 min (range, 26-40 min), and the mean hospitalization time was 6 days ( range, 3-8 d) .There was no complications, such as infections or stiffnesses.All the patients were followed up for 2 -3 years.Subjective symptoms improved significantly after arthroscopic partial meniscectomy.According to the Lysholm knee scoring scale, the scores were (71.1 ±6.6) points preoperatively and (92.0 ±3.4) points postoperatively, with significant difference (t=10.530, P=0.000). Conclusion Diagnosis of hidden horizontal tears of the medial meniscus posterior horn is often difficult, because most patients have osteoarthritic knees.Careful physical examination and MRI are critical for making a correct diagnosis.Arthroscopic partial meniscectomy can help patients obtain better results.

Objective To investigate the relationship between the expression of MMP-10 and the invasion and metastasis in esophageal cancer. Methods The expression of MMP-10 and mean microvessel density (MVD) in 54 specimens were examined by immunohistochemical stain. Results The MMP-10 expression in the tumorous tissue was significantly correlated with lymph node metastasis, invasionand TNM stage(P

[Objective]To discuss the efficacy of medial wedged proximal tibial osteotomy for treating genu varus deformity.[Methods]From July 1998 to October 2007,49 patients with genu varus deformity were treated by medial wedged proximal tibial osteotomy combined with internal fixation.Full-length anterior-posterior radiographs were taken preoperatively at 8 weeks and 1.5 years postoperatively.The parameters including the femorotibial angle and the medial joint space were measured on the radiographs.The pre-and postoperative function of knee were evaluated according to the HSS score system of the knee.[Results]All the 49 patients were followed up from 18 to 128 months.The mean postoperative femorotibial angle decreaced from 187.5??5.3? to 172.6??3.6?.The mean postoperative HSS score significantly improved from 83.2?15.3 to 47.2?17.6 points after 1.5 years of operation.The medial joint space increased from(2.4?1.2) mm to(4.3?1.2) mm.There were complications in 5 cases: 3 cases of intra-articular fracture during operation and 2 of postoperative superficial wound infections.There were no delayed union,no recurrence of varus deformity,and no blood vessels or nerves injury in all cases.The pain relieved and walking function improved significantly postoperativly.[Conclusion]Medial wedged proximal tibial osteotomy combined with internal fixation is an effect approach to treat genu varus deformity.

Objective To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation (OLT) treated with the interventional techniques.Methods The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables (including biliary complication, hepatic artery restenosis,early or late artery complication, and so on) were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of percutaneous interventional treatment for hepatic artery complications after OLT. Results Twenty-one patients were followed for mean 436 days, median 464 days (3-1037 days). The poor-prognosis group included 11 patients (5 cases received retransplantation, and 6 died). The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days (3-616 days). The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days (245-1037 days).Univariate analysis showed there were significant difference in biliary complication, total bilirubin and indirect bilirubin between the two groups. The binary logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management (P = 0.027, OR =22.818). Conclusion Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombisis receiving interventional treatment.

Objective To evaluate the possibility and reliability of laparoscopic management of cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice. Methods Eleven patients with cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice who underwent laparoscopic management were retrospectively studied.Results Ten cases were successful with laparoscopic management,among the total,4 patients were underwent laparoscopic cholecystectomy (LC),6 cases were experienced LC and laparoscopic common bile duct exploration (LCBDE).One case was converted to open operation.No serious complications were observed.All the patients were cured after the operative treatment.None of the complications could be traced after follow-up for 6 months. Conclusions Cholelithiasis merging extrahepatic and acalculous and benign obstructive jaundice is a challenge to laparoscopic surgeons.Intraoperative diagnosis is very difficultly,but very important.It is better prognosis by careful and skilled operators and reasonable operative method to be chose.

Precision registration of serial sections is an important step for 3-D image reconstruction. It directly affects the accuracy of the reconstructed result and parameter computation. This problem has been studied and demonstrated by many investigators, but the whole process has not yet reached good performance. In this paper, we discussed the registration of serial sections image of mandible and put forward a method of the soft registration-based transformation on the basis of the hard registration in consideration of the speciality of 3-D image reconstruction for the serial sections of mandible. Employing control points and using Affine Transformation and Extended Hough Transformation, we solved the problem of displacement on 3-D image reconstruction for serial secons and paved the way for reconstructing the mandible microstructure with reality. The results of experiments indicate that the 3D image reconstructed after registration has only a little distortion.
Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Mandible ; diagnostic imaging ; Tomography, X-Ray Computed

Objective To analyze primary diseases and risk factors of chronic cough in children,and develop clinical thinking for the doctor,looking for the orderly diagnosis method.Methods The clinical data of 123 children with chronic cough(medical history,physical examination,routine chest X-ray,PPD test,mycoplasma,Chlamydia antibody,antibody of respiratory syncytial virus,adenovirus IgM determination of IgM determination,Coxsackie virus IgM determination,when necessary,be lung CT,CT of paranasal sinuses,gastrointestinal barium meal,bronchiectasis agent diagnostic treatment and surgery consultation) were retrospectively analyzed.The cause of chronic cough in children with primary disease and related factors were analyzed.Results 123 cases of chronic cough in children's primary diseases were asthma-related cough in 57 cases (46.3 %),upper airway cough syndrome (rhinitis,allergic rhinitis,sinusitis) in 41 cases (33.3 %),chronic pharyngitis and tonsillitis,bronchitis in 27 cases (22.0%) ; the main etiology for Mycoplasma Chlamydia(48.8%,60 cases adenovirus),19 cases(15.4%),12 cases of respiratory syncytial virus (9.8%).Conclusion The main primary disease cough,asthma associated upper airway cough syndrome,chronic pharyngitis and tonsillitis,bronchitis,chronic cough in children,the main pathogen Chlamydia,Mycoplasma-for adenovirus,respiratory syncytial virus infection,diagnosis should be based on detailed,comprehensive medical history and physical examination,from simple to complex,according to from low to high,from conventional to special,from noninvasive to invasive principles are examined.

Objective To determine the clinical value of MRCP for peroperative evaluation of donor biliary system in living donor liver transplantation (LDLT). Methods A total of 60 living donors for the LDLT were enrolled in this study. Of the 60 donors with a mean age of 32.2 (19-60), 50were male and 10 female. MRCP was performed before and cholangiography was done during the right lobectomy in these donors. The results of MRCP were compared with those of cholangiography to determine the value of MRCP for typing the biliary system in the donors. Results The preoperative MRCP showed that 40 donors were of type Ⅰ biliary tract, 12 of type Ⅱ , 5 of type Ⅲ and 3 of other types. The intraoperative cholangiography showed that the accordance rate of MRCP was 97.4%,91% and 89% for type Ⅰ , type Ⅱ and other types, respectively. The overall rate of accuracy of MRCP was 95% (57/60). Conlusion MRCP can show types of biliary tract in living donors for liver transplantation to provide evidence for plan of surgery.

Objective To investigate the clinical features of pulmonary infection in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).Methods A total of 666 hospitalized patients with HBV-ACLF in Department of Liver Disease of Fuzhou Infectious Diseases Hospital were retrospectively analyzed.Data of demographic and clinical parameters (sex,age,presence of liver cirrhosis and diabetes),complications (spontaneous bacterial peritonitis,hepatorenal syndrome,hepatic encephalopathy,and upper gastrointestinal hemorrhage),and baseline biochemical parameters were collected from the medical records database.Univariate and multivariate regression analyses were performed to determine the independent risk factors of pulmonary infection in patients with ACLF.Distributions of the pathogenic bacteria were further analyzed.Student t test was used for the means consistent with normal distribution,while non-parametric statistics were used for the data consistent with abnormal distribution.Mann-Whitney U test was used for the data between two groups.Chi square test and Fisher exact probability method were used for comparing the count data.Results A total of 125 out of 666 patients with ACLF developed pulmonary infection.The incidence of pulmonary infection was 18.76 ％ (125/666)..Most patients were infected with fungi (54.84％).The incidence rate of pulmonary infection in patients with liver failure over 60 years (41.18％) was significantly higher than that in patients under 60 years (16.91％;x2 =19.136,P＜0.01).The incidence of cirrhosis or diabetes in the 125 patients with pulmonary infection was higher than patients with no pulmonary infection.The difference between the two groups was statistically significant (P＜0.01).Levels of albumin,cholesterol,alphafetoprotein,white blood cell count,hemoglobin,plasma thromboplastin antecedent,international normalized ratio (INR),and serum sodium were all significantly different between the two groups (all P＜ 0.05).The incidence of spontaneous bacterial peritonitis,hepatorenal syndrome,and hepatic encephalopathy in patients with pulmonary infection were significantly higher than those without pulmonary infection (P＜0.01).Spontaneous bacterial peritonitis,age,albumin,hemoglobin and serum sodium were important factors in the development of the pulmonary infection.And albumin,hemoglobin and serum sodium were protective factors.Conclusions Pulmonary infection,as one of the common and serious complications,significantly affects the prognosis of liver failure patients.Prediction of pulmonary infection in the early stage is essential.Patients with elder age,spontaneous bacterial peritonitis,low albumin level,low serum sodium level and low hemoglobin level should be timely monitored to prevent the development of pulmonary infection.