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 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 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 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 investigate the relationship between hepatitis B surface antigen (HBsAg) levels and liver pathology at different phases of natural history in chronic hepatitis B (CHB) patients, and to establish a non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Methods A total of 145 CHB patients were enrolled and underwent liver biopsy from January 2013 to January 2015, among which 73 patients were hepatitis B e antigen (HBeAg) positive.HBsAg levels and HBV DNA levels were compared between patients at different phases of natural history and between patients with different HBeAg statuses.Logistic analysis was used to analyze the risk factors associated with fibrosis in HBeAg-positive patients, and to evaluate the predictive value of non-invasive liver fibrosis diagnostic model based on HBsAg quantification.Analysis of variance was used for statistical analysis, and t test analysis was used for the comparison between two independent samples.Results The serum HBsAg levels at the immunologic tolerance phase, immunologic clearance phase, low copy phase and reactivation phase of CHB patients were (4.29±0.69), (3.56±0.61), (3.22±0.64), and (3.54±0.50) lg IU/mL, respectively (F=16.72, P<0.01), and the HBV DNA levels were (8.48±0.58), (6.69±1.44), (3.80±0.59), and (6.21±1.06) lg IU/mL, respectively (F=76.73, P<0.01).In HBeAg-positive CHB patients with liver inflammation stage (G)≤G1, G2, G3 and G4, the serum HBsAg levels were (4.44±0.65), (4.00±0.72), (3.74±0.62), and (3.28±0.50) lg IU/mL, respectively (F=9.198, P<0.01).In HBeAg-positive CHB patients with liver fibrosis stage (S)≤S1, S2, S3, and S4, the serum HBsAg levels were (4.55±0.54), (4.04±0.89), (3.59±0.63), and (3.34±0.50) lg IU/mL, respectively (F=10.66, P<0.01).Logistic analysis showed that age (OR=1.091, 95%CI: 1.013-1.175) and HBsAg level (OR=0.190, 95%CI: 0.066-0.542) were independent factors for predicting fibrosis stage.The area under receiver operating characteristic curve of the non-invasive fibrosis model based on age and HBsAg level was 0.849, which was higher than aspartate aminotransferase to platelet ratio index (0.749) and fibrosis index based on the 4 factors (0.763).Conclusions The serum HBsAg levels are significantly different among the different phases of natural history in CHB patients.The serum HBsAg levels decline with the progression of liver fibrosis in HBeAg-positive CHB patients.The non-invasive diagnostic model that based on HBsAg quantification could be used to evaluate the stage of liver fibrosis.

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.

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.

Aim To investigate the vasodilatory effect of Ferulic acid on in vitro rat coronary artery and its possible mechanism. Methods By using the mi-crovessel tension recorder system, the vasodilatory effect of FA on resting and contractin-vitro rat coronary artery was determined;the influence of endothelial in-tegrity to FA-induced vasorelaxation was observed; the relationship of FA on [ Ca2+] ex-influx-induced and [ Ca2+] in-efflux-induced contractions was discussed;the mechanism of vasodilatory effect of FA was ex-plored by applying the inhibitors of KCa(TEA),KATP channel ( Gli ) , KIR channel ( BaCl2 ) , KV ( 4-AP ) , NOS( L-NAME) and COX( Indo) . Results FA had no effect on the resting tension of in vitro rat coronary artery. FA dilated the in-vitro rat coronary artery pre-treated with KCl ( 60 mmol · L-1 ) , U46619 ( 1 μmol · L-1 ) and PE ( 10μmol · L-1 ) in a concentration-dependent fashion ( P < 0. 05 ) . FA inhibited the [ Ca2+] ex-influx-induced and [ Ca2+] in-efflux-in-duced contractions significantly ( P <0. 05 ) . 4-AP ( 1 mmol· L-1 ) restrained the diastolic function of FA, while TEA, Gli, BaCl2、L-NAME, Indo had no obvious effect ( P >0. 05 ) . Conclusion The diastolic func-tion could be related to the activation of KV channel on vascular smooth muscle cells, the free Ca2+ from Sar-coplasmic reticulum cells and blockade extracellular Calcium channel do not depend on KCa, KATP, KIR channel, nor the endothelial function.