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 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 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 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.

Objective To investigate the nutritional status of children and women of childbearing age in high-risk areas of iodine deficiency disorders in Tianjin in 2008-2010 and to provide a scientific basis for iodine supplementation.Methods Hangu District was selected as survey point from 2008 to 2010,Dagang District and Jingan County were increased in 2010.Hangu District was divided into five areas,one township(town) that was not high iodine was selected from each area,four administrative villages were selected from each township(town),and 15 households were selected from each administrative village.Three township(town) were selected from Dagang and Jingan County,respectively.Two administrative villages were selected from each township(town),and 20 households were selected from each administrative village.Iodine level of salt samples from each household was determined.In 2009,one primary school was selected from each survey township(town),thyroid volume of 40 8-10-year-old students was examined,and urine iodine of 20 students was tested.In 2010,three township(town) were selected from each survey point,two primary school were selected from each survey township(town),40 8-l0-year-old students were selected from each primary school,urine iodine and thyroid volume of the students were determined.150,50 and 60 women of childbearing age from Hangu District were selected from 2008 to 2010,and 60 were selected from Dagang District and Jingan County,respectively.Urine iodine of the women was tested.Iodine content of salt was tested by a semi-quantitative test kit; diagnosis of endemic goiter was based on the Diagnostic Criteria of Endemic Goiter (WS 276-2007); urinary iodine test was based on the Arsenic Cerium Catalytic Spectrophotometry (WS/T 107-2006).Results Coverage rates of iodized salt in Hangu District in the 3 years were 65.0％ (195/300),70.3％ (211/300) and 90.8％ (274/300),respectively.Coverage rates of iodized salt in Dagang District and Jinghai County were 40.0％(48/120) and 38.3％(46/120).In 2009,the median urinary iodine of children aged 8-10 in Hangu District was 205.4 μg/L and in 2010,the medians urinary iodine of children aged 8-10 of the three survey point were 193.0,293.1 and 216.8 μg/L.Goiter rates of children aged 8-10 in Hangu District were 4.24％(9/212) and 3.59％ (9/251),and in Dagang District and Jinghai County were 3.60％ (9/250) and 5.44％(13/239).The medians urinary iodine in women of childbearing age in Hangu District in the 3 years were 134.9,196.1 and 229.5 μg/L,respectively.The medians urinary iodine in women of childbearing age in Dagang District and Jinghai County were 316.9 and 190.9 μg/L.Conclusions The nutritional status of high-risk areas of iodine deficiency disorders in Tianjin are better than the national limit of enhanced iodine requirements.Due to higher water iodine in the same areas,some people are iodine excess,to which we should pay more attention.

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.

AIM:To explore the mechanisms underlying contraction induced by extracelluar acidosis (pHex6.8) in rat isolated coronary artery (RCA).METHODS:Using the microvessel tension recorder system, the effects of acid-base transporters on RCA contraction induced by pHex6.8 were explored by applying the selective pharmacological inhibitors of Na+-H+ exchanger 1 (NHE-1) and Na+-HCO-3 cotransporter (NBC), HOE-642 and S0859, respectively.The effects of chloride channel on RCA contraction induced by pHex6.8 were explored by applying the inhibitors of chloride channel (NPPB and NFA), and by replacing the extracellular NaCl with equimolar NaBr.RESULTS:pHex6.8 augmented the resting tension of RCA, and the maximum contraction was (3.90±0.95) mN.HOE-642 at 30 μmol/L and S0859 at 100 μmol/L both inhibited the contraction of RCA induced by pHex6.8 (P<0.01).NPPB and NFA both inhibited the contraction of RCA induced by pHex6.8 or KCl (60 mmol/L) in a concentration-dependent manner.NPPB and NFA (100 μmol/L) both inhibited the contraction of RCA induced by U46619 (1 μmol/L).Replacing the extracellular NaCl with equimolar NaBr almost completely inhibited RCA contraction induced by pHex6.8 (P<0.01), but had no obvious effect on the contraction induced by KCl (60 mmol/L) or U46619 (1 μmol/L).CONCLUSION:Extracellular acidosis-induced contraction in RCA may be related to the activated NHE-1 and NBC, and it may be also related to the enhanced chloride transport across the membrane.

Objective To investigate the guidance value of TOI classification in treating traumatic T-type atlantoaxial dislocation (ADD).Methods A retrospective case series study was made on 32 cases of traumatic TOI T-type ADD treated between January 2012 and December 2015.There were 19 males and 13 females,aged (38.4 ± 14.7) years.Fifteen cases of T1-type underwent external fixation or internal fixation without fusion,while 17 cases of T2-type underwent internal fixation with fusion.Symon-Lavender clinical standard,Japanese orthopedic association score (JOA),visual analogue scale (VAS),atlas-dens interval (ADI) and space available for the cord (SAC) were used to evaluate the therapeutic effect.Results Patients were followed up for 6-54 months (mean,32.4 months).At final follow-up,ADI was decreased to (2.3 ± 1.4) mm from preoperative (5.6 ± 1.6) mm,but SAC was increased to (15.4 ± 1.9) mm from preoperative (12.0 ± 2.9) mm(P ＜ 0.01).At final follow-up,cervical axial rotation range of motion was 102°-154° in T1-type cases and 57°-93° in T2-type cases.Range of motion for atlantoaxial joint was preserved in T1-type cases,but lost in T2-type cases.According to the Symon-Lavender clinical standard,there were 14 cases of mild disability,nine moderate disability,eight severe disability and one extremely severe disability before operation;there were 21 cases of mild disability,nine moderate disability and two severe disability at last follow-up.Significant difference was observed in the grades according to the Symon-Lavender clinical standard before operation and at last follow-up (P ＜0.05).At last follow-up,JOA score was increased to (14.6 ± 2.9) points from preoperative (9.9± 3.2) points,and VAS was decreased to (2.7 ± 1.3)points from preoperative (6.0 ± 1.6)points (P ＜ 0.01).Conclusions By using TOI classification,reconstruction of stability and improved neurological function can be achieved in treatment of traumatic T-type atlantoaxial dislocation.Non-fusion treatment of T1-type atlantoaxial dislocation can preserve range of motion for atlantoaxial joint.