Objective:To explore the clinical effect of the emergency surgical treatment of tracheobronchial injury.Methods:11 operative patients with tracheobronchial injury were studied and analyzed.Results:8 patients were emergcntly operated with thoracotomy through tracheobronchial repair.2 cases suffered left inferior pulmonary atelectasis after operation and they healed with sucking sputum through tracheal cannula and positive-pressure ventilation.Right subphrenic abscess occurred in 1 case,and the patient healed with exploratory laparotomy and drainage.There were no death and no bronchopleural fistula or bronchostenosis after operation.Conclution:The emergency tracheobronchial prosthesis through thoracotomy is an important treatment for tracheobronchial injury,which is safe and accompanied with less complications.

Genetic susceptibility factor is one of the important reasons to induce breast cancer. Breast cancer risk variants are divided into three categories including high, moderate and low penetrances. Traditional BC susceptibility gene discovery approaches limit the search for breast cancer susceptibility genes with high and moderate risk variants. Whole exome sequencing technology provides a quick and efficient method to discover breast cancer susceptibility genes. At present, a number of breast cancer susceptibility genes have been identified by whole exome sequencing method, which provides useful guidance for the risk assessment and pathogenesis of hereditary breast cancer. In this paper, we reviewed the whole exome sequencing technology and discussed the experimental design, data filtering strategy, statistical significance and correlation analysis.

Objective To detect the expression of islet amyloid polypeptide (IAPP) in the pancreatic tissues of patients with pancreatic cancer,and to explore the relation between diabetes and pancreatic cancer.Methods Surgically-removed 28 pancreatic cancer samples and adjacent normal pancreatic tissues were studied.Among these patients there were 12 patients complicated with diabetes while other 16 patients did not.Immunohistoehemieal method and Western blot method were used to detect the expression of IAPP in different tissue specimens.Results lAPP expressed in human pancreatic islet cell cytoplasm.Immanohistochcmical index of pancreatic cancer and adjacent normal pancreatic specimens of patients with diabetes,and pancreatic cancer and adjacent normal pancreatic specimens of patients without diabetes were 283 305±91 627,122 874±86 917,154 032±81 097 and 105 797±67 593,respectively;the relative IAPP expressions were (173.1±23.5) %,( 119.4±18.4) %,( 148.7±28.3 ) % and 100%.Irrespective of the presence of diabetes,expression of IAPP in pancreatic cancer specimens was significantly higher than that in adjacent normal pancreatic specimens ( P ＜ 0.01 );expression of IAPP in pancreatic cancer plus diabetes specimens was significantly higher than that in pancreatic cancer specimens without diabetes (P ＜0.01 );expression of IAPP in adjacent pancreatic specimens complicated with diabetes was significantly higher than that in adjacent pancreatic specimens without diabetes ( P ＜ 0.05).Conclusions LAPP participated in the course of diabetes and pancreatic cancer,and may be the common pathogenesis of the two diseases.

To explore the relationship between clinical findings and pathological changes of IgA nephropathy (IgAN), 37 children with IgAN were undertaken clinical classification and renal-pathological comparison including glomerulus change, renal tubule-interstitial change and immunopathology. The results showed that there were 18 (49%) cases with hematuria, 14 (38%) cases with nephrotic syndrome, 3(8%) cases with both of hematuria and proteineuria, and 2 (5%) cases with nephritic syndrome in the clinical classification. 54% of cases with glomerulus changes was as class III. No significant relationship was found between clinical classification and glomerulus changes. There were 24 cases with renal-tubule interstitial changes and 7 cases with hematuria. 43% of them were classified as class I and 57% as class II.All cases with nephrotic syn-drome developed renal tubule-interstitial change. 78% (11 cases) of them were as class II and 22% (3 cases) as class III. Besides, 2 of 3 cases with both of hematuria and proteineuria and 1 of 2 cases with nephritic syndrome also manifested renal tubule-interstitial change. There were four phenotypes were observed in immunopathology including 16 cases of them as IgA, 6 cases as IgAG, 10 cases as IgAM and 5 cases as IgAGM, respectively. 66% of cases with hematuria was found as IgA and 50% of cases with nephrotic syndrome as IgAM. It is concluded that hematuria can be a main clinical finding in both of IgAN and nephrotic syndrome. Glomerulus changes is usually not correlated with clinical classification. There is a significant renal tubule-interstitial change in cases with nephrotic syndrome. Hematuria is usually as IgA and nephrotic syndrome as IgAM in immunopathology.

Scleral buckling surgery is a main surgical method for rhegmatogenous retinal detachment, and it is the basic skill of retinal surgeons. As a kind of classic treatment, retinal surgeons must recognize and understand the essence and connotation of scleral buckling surgery, master and apply skillfully, improve the success rate of rhegmatogenous retinal detachment, and use the minimum amount of surgical combination to achieve anatomical retinal reattachment and restore visual function as much as possible.

Arrhythmias, Cardiac ; diagnosis ; genetics ; pathology ; Brugada Syndrome ; diagnosis ; genetics ; pathology ; Channelopathies ; diagnosis ; genetics ; pathology ; DNA Mutational Analysis ; Electrocardiography ; Genetic Testing ; Heart Conduction System ; physiopathology ; Humans ; Infant ; Long QT Syndrome ; diagnosis ; genetics ; pathology ; Muscle Proteins ; genetics ; Mutation ; NAV1.5 Voltage-Gated Sodium Channel ; genetics ; Sodium Channels ; genetics ; Sudden Infant Death ; etiology

Objective To evaluate the effect of HTK solution on myocardial protection during valve replacement surgery.Methods 42 patients with rheumatic heart disease were randomized to receive 4∶1cold blood (control group,n =21 ) and HTK ( protective gronp,n =21 ) cardioplegic solution during valve replacement.The changes of CO and CI were collected at different time points including pre-operation,postoperative 6 hours,12 hours and 24 hours.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery and inotropic drugs application were calculated,and mechanical ventilation support time and the incidence of arrhythmia were recorded.Results The measurements of CO and CI showed that there was significant higher level in protective group at postoperative 12 hours and 24 hours [ 12 h:(4.82 ± 0.18 ) L/min vs ( 3.50 ± 0.32 ) L/min,( 3.80 ± 0.48 ) L/( min · m2 ) vs (2.79 ± 0.39) L/( min · m2 ) ;24 h:(4.97±0.45)L/min vs ( 3.81 ±0.19)L/min,(4.22±0.17)L/(min · m2) vs (2.91 ±0.21)L/(min·m2 ),P ＜ 0.05].The clinical parameters including aortic clamping time,incidence of cardiac arrhythmia,inotropic support,duration of mechanical ventilation and length was lower than in control group [ (53.6 ±24.3 ) min vs ( 68.9 ± 26.1 ) min ; ( 1.8 ± 1.3 ) min vs ( 2.3 ± 1.2 ) min ; ( 33 ± 11 ) min vs ( 42 ± 13 ) min ;(10.2±2.1) μg/(kg · min) vs (15.7 ±3.8) μg/(kg · min);(14.6 ±4.8)h vs (20.7 ±5.1)h,P ＜0.05].The auto-beating rate was higher than in control group (90％ vs 67％,P ＜0.05).Conclusions HTK solution is better than classical blood cardioplegia in myocardial protection during valve replacement.

The CT images of 42 pathologically confirmed cases of gastrointestinal stromal tumors were reviewed, and compared with pathological results. In 20 cases, the lesions were located in stomach, 21 in small intestine, 1 in mesentery. In 18 cases pathologically confirmed as benign tumors, 16 were positive on CT scan, which presented round solid mass with homogeneous density, mean diameter of 3.8 cm (2 -6 cm), homogeneous enhancement on post-contrast scan. In 21 malignant cases all were on CT scan, which presented irregular or lobulated solid mass with heterogeneous density and cystic change inside, mean diameter of 10. 1 cm (4 - 30 cm) , heterogeneous enhancement with no enhancement in cystic part. In 3 potentially malignant cases, CT images showed irregular solid mass with homogeneous density, diameter of 4 - 8 cm, homogeneous enhancement in post-contrast scan. CT scan can accurately show the location and size of gastrointestinal stromal tumors, and is of important diagnostic value.

Objective To investigate the effects of different concentration propofol target controlled infusion on postoperative cognitive function in patients undergoing coronary artery bypass grafting.Methods182 cases with coronary heart disease undergoing off-pump coronary artery bypass grafting were randomly divided into groupA and groupB from January 2014 to December 2016 in our hospital, 91cases in each group.GroupA were given a small dose propofol target controlled infusion anesthesia;groupB were given high dose propofol target controlled infusion anesthesia.The total dose of propofol induction and effect compartment concentration in the two groups were observed, and the Mini Mental State Examination(MMSE) in the two groups was evaluated preoperative, postoperative 24h, 48h, 72h.Concentration of S100β was determined at suture, postoperative 24h, 72h.ResultsThe total dose of propofol induction in the groupA was significantly lower than that in the groupB (P<0.05), effect compartment concentration between the two groups had no statistically significant difference.MMSE scores in the group A at postoperation 24h, 48h, were higher than those in the group B (P<0.05).Concentration of S100β in the group A was lower than those in the group B at suture, postoperative 24h, 72h.MMSE and concentration of S100β in the two groups were not statistically significant at post operation 72h.ConclusionLow dose propofol target controlled infusion can reduce postoperative cognitive dysfunction in patients undergoing coronary artery bypass grafting, which is worthy of clinical application.

Objective To investigate the clinical effect of caffeine citrate combined with continuous positive airway pressure( CPAP) in the treatment of primary apnea of prematurity.Methods 80 premature infants with primary apnea who received therapy from January 2014 to August 2015 were selected as research subjects.According to ran-dom number table,the infants were divided into two groups equally.Besides conventional treatments,the control group received treatment of caffeine citrate,while the observation group received CPAP and caffeine citrate.Then,the cura-tive efficacy,situation of apnea and adverse reactions were compared.Results The total effective rate between the observation group and the control group had statically significant difference(95.0%vs.77.5%,P<0.05) .Compared with the control group,the observation group had statistically less seizure frequency,shorter duration of seizure and disappearance time of symptoms(all P<0.05).During the treatment,incidence rates of tachycardia,dysphoria and electrolyte disturbance in the observation group were statistically lower than those in the control group (all P<0.05), while the incidence of feeding intolerance in the two groups had no statistically significant difference ( P >0 .0 5 ) . Conclusion Caffeine citrate in combination with CPAP is effective for primary apnea of prematurity,which can sig-nificantly increase curative efficacy,lessen seizure frequency of apnea,shorten duration of seizure and disappearance time of symptoms with less adverse reactions.