Sixty-four patients with solitary pulmonary nodules were included in this study. The diameter of pulmonary nodules was equal or less than 3.0 cm and no contact with the adjacent pleura. They were divided into study group( with acuductor locating method)and conventional group (with conventional method). The results showed that the one-time success rates were 97％ (31/32)in study group and 72％(23/32) in conventional group, the diagnostic accuracy were 94％ ( 30/32 ) and 88 ％ ( 28/32 ), respectively,while the successful puncture time were( 13. 5 ±4. 9)min and( 18. 7 ±5. 7) min, respectively. In study group,the complication rate was 9％ (3/32), while 28％ ( 9/32 ) in conventional group. There were statistical differences between the two groups. CT-guided aspriation biopsy for solitary pulmonary nodules with self-made acuductor can obviously improve one-time success rate and reduce the complication rate and operative time.

AIM To observe the effects of Guhoukang Granules (Eucommiae Cortex,Dipsaci Radix,Corni Fructus,etc.) on bone metabolism indexes of the geriatric femoral intertrochanteric fracture.METHODS A total of eighty patients meeting the inclusion criteria,cured with fixed operation of proximal femoral anti-rotation nail and given basic care,were divided randomly and equally into two groups:experiment group (Guhoukang Granules ) and control group (calcium carbonate D3 tablets).Three months made a course.Osteocalcin (OC),calcitonin (CT),bone-specific alkaline phosphatase (BALP),total procollagen type 1 aminoterminal propeptide (tPINP),β isomer of the C-terminal telopeptide of type Ⅰ collagen (β-CTX),and intact parathyroid hormone (iPTH),were examined before and after three months,respectively.RESULTS There were no significant statistical difference in the levels of OC,CT,BALP,tPINP,β-CTX and iPTH before operation in both groups.The levels of OC,CT,BALP,tPINP in the experiment group obviously increased and the levels of β-CTX,iPTH markedly decreased after the operation,and were better than those in the experiment group pre-operation and in the control group after the operation.The control group had no improvement in bone metabolism indexes pre-and post-operation.CONCLUSION Guhoukang Granules can improve bone metabolism of the geriatric femoral intertrochanteric fracture and facilitate the recovery of the fracture.

Objective To explore the effect of different controlled hypotension method on the blood flow of the vertebral vein by measuring of blood flow of vertebral vein in rabbits. Methods Eighteen New Zealand rabbits,weighing 2-3 kg,were rando mly divided into three groups (n =6 each).Group S maintained MAP (90±5)mm Hg,group GTN reduced MAP to the base value of (70±10)% by using nitroglycerin 0.5 μg·kg-1 ·min-1 and esmolol 2.5 μg·kg-1 ·min-1 (ni-troglycerin∶esmolol= 1∶5 ),group SNP reduced MAP to the base value of (70 ± 10 )% by using sodium nitroprusside 0.5 μg·kg-1 ·min-1 and esmolol 2.5 μg·kg-1 ·min-1 (sodium nitroprusside∶es-molol=1∶5).The controlled hypotension model was established after intravenous general anesthesia. The blood flow of vertebral vein in rabbits were measured by ultrasonic measurement system (Terason 2 000 system ) before controlled hypotension and 1 hour after controlled hypotension. Results The MAP before controlled hypotension in group S (89.0 ± 5.2 )mm Hg,group GTN (91.5± 9.6 )mm Hg,group SNP (92.0 ± 5.7 )mm Hg had no significant difference.The blood pressure before and after the experiment had no significantly difference in group S.The blood pressure after controlled hypotension had no significant difference in group GTN and group SNP,but lower than that before controlled hypotension (P <0.05).Compared with group S,the blood flow of verte-bral vein in group GTN and group SNP were significantly reduced (P < 0.05 ).The blood flow in group GTN was significantly reduced compared with that in group SNP (P <0.05 ).Conclusion In the experiment,the combination of nitroglycerin and esmolol can better reduce blood flow of vertebral vein than that of nitroprusside and esmolol,that it is suitable for the control of hypotension in spinal surgery.

Objective To observe serum sCD40L,MMP9 levels and their relevance with different types of coronary heart disease(CHD).Methods The present study was involved in 90 patients with CHD,including acute myocardial infarction(AMI)30 case,unstable angina pectoris(UAP)31 case,stable angina pectoris (SAP)29 case and another 25 normal controls.The serum MMP9 and sCD40L levels were detected with enzyme-linked immunosor-bent assay.Results The levels of MMP9,sCD40L in AMI and UAP group were significantly higher than those in SAP group[(69.48 ±4.76)ng/mL,(66.61 ±5.30)ng/mL,(30.44 ±7.66)ng/mL,t=1.425,0.075,all P<0.05], there were no statistically significant differences in the serum MMP9,sCD40L levels between AMI group with UAP group (all P>0.05 ),and also there were no ststitically signiticant differeces in the serum MMP9,sCD40L levels between SAP group with control group (all P>0.05).MMP9 level in AMI and UAP group was positively related with sCD40L (r=0.96,P<0.01 and r=0.97,P<0.01 ).Conclusion The serum sCD40L and MMP9 levels of acute coronary syndrome(ACS)increase significantly,and can be used as an important index to assess the severity of CAD and predict the instability of plaque in CAD patients.

Objective To observe the changes of ischemia modified albumin (IMA),high -sensitivity C -reactive protein (hs -CRP)after percutaneous coronary intervention (PCI).The factors related to intervention procedures to patients with IMA and hs -CRP elevation after PCI and impact of the risk of IMA and hs -CRP on the clinical outcomes were investigated.Methods IMA,hs -CRP from vein blood of 90 cases received PCI were detec-ted before operation and after operation at time of 30 min,2h,6h and 24h.The clinical characteristics of patients and factors related to intervention procedures were recorded.The number of lesion vessels and the relative factors in PCI were compared.The clinical outcomes of the patients were followed up.Results After operation,IMA was significantly different compared with that before operation (t =2.293,P <0.05).The concentration of IMA peaked at 2h after operation,which was significantly different from that before surgery (t =1.116,P <0.01).The increase of IMA and hs -CRP were closely related with the inflation pressure,total times of inflation,dilated times,length and diameter of stent and the number of stents (t =3.678,P <0.01 ).The angina onset was more common and length of stay was longer in the patients with the rise of IMA and hs -CRP.Conclusion PCI may cause myocardial injury,which is associated to inflation pressure,total time of inflation,dilated times,length and diameter of stent and the number of stents.To a certain extent the level of troponin can predict the outcomes.

Objective To investigate the supplementary roles of MRI in the diagnosis of fetal abnormalities in twin fetuses.Methods MRI manifestations of 22 twins were retrospectively analyzed after abnormalities were found by prenatal ultrasonography (US) from Sep 2005 to Dec 2012.Two rapid scanning sequences were used in the study,fast-imaging employing steady-state acquisition (FIESTA) and fast inversion recovery motion insensitive (FIRM).MRI findings were compared with those of prenatal US,induced labour or postpartum diagnosis.Results A total of 22 twins were reported with 23 abnormal fetuses in 20 twins and 2 normal twins.MRI confirmed central nervous system abnormalities in 3 abnormal fetuses which were anencephalus,meningoencephalocele and enlargement of lateral ventricles respectively.The case of meningoencephalocele was showed brain tissue protruding from the occipital defect on MRI,which was misdiagnosed as a cystic lymphagioma by US.The MRI diagnosis of anencephalus and enlarged lateral ventricles were accordant with US.MRI made the definite diagnosis in 5 chest abnormalities,which were left congenital diaphragmatic hernia (CDH) in 5 abnormal fetuses.They were diagnosed as possible CDH by US.Abdominal abnormalities (n=7,8 abnormal fetuses) included two fetuses in one twin with expanded digestive tract,one fetus with expanded colon and rectus and five fetuses with omphalocele.MRI diagnosis was compatible with US diagnosis in the 7 cases.Twins micromelia were found in one case with 2 abnormal fetuses.Conjoined twins in chest and abdomen were found in another case,which manifested as two hearts,one shared liver and independent urinary tracts and gastrointestinal tracts on MRI.One fetus in twin was dead (n=1,1 abnormal fetus).MRI showed small size and skin edema of the dead fetus.One acephalus acardius of twins (n=2,2 abnormal fetuses) was proved.Normal MRI manifestations were indicated in 2 cases which were suspected by US for abnormal digestive tract and cryptorachischisis respectively.Conclusions MRI,an important supplementary method of prenatal US diagnosis,shows valuable advantages including multi-plane manifestations,more extensive visual field and good soft tissue contrast.It is especially helpful in the diagnosis and treatment of multiple pregnancy.

Objective To explore the risk factors of central neck lymph node metastases in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) and the rationality of prophylactic central neck dissection. Methods The clinical data of 1359 patients who had underwent PTC treatment at the Department of Head and Neck Surgery , Henan Provincial Cancer Hospital during the five years (from 2011-01 to 2015-12) were analyzed retrospectively. Results There were 376 patients (27.67％, 376/1359) with central neck lymph node metastases. Single factor analysis and multivariate Logistic regression analysis showed that the central neck lymph node metastases were related to tumor max diameter≥10 mm, extrathyroidal extension (P<0.01), age<55 years old (P<0.01), multifocality (P<0.01), and PTC located at the isthmus (P<0.01). Conclusions Risk stratification should be performed on cN0 PTC. Prophylactic central neck dissection should be performed in cN0 patients with the tumor max diameter ≥ 10 mm, capsule invasion, age <55 years, multiple tumors, isthmus PTC and Hashimoto thyroiditis patients.

Objective To explore the prognostic factors of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Methods A total of 462 esophageal neoplasms patients treated by traditional Chinese medicine combined with radiotherapy from March 2009 to March 2012 in Civil Administration Hospital of Hebei Province were retrospectively analyzed.The overall median survival time and the survival rate of 1,3 and 5 years were calculated by using life table.Log-rank test was used for single-factor analysis and Cox model was used for multiple-factor analysis.Results The median survival time of 462 esophageal neoplasm patients was 24.2 months (12.9-36.6 months).The survival rate of 1,3 and 5 years was 80.3 ％,30.6 ％ and 10.5 ％ respectively.Single-factor analysis showed that the age (x2 =89.773,P =0.000),tumor diameter (x2 =102.373,P =0.000),clinical staging (x2 =128.903,P =0.000),concomitant with other diseases (x2 =65.366,P =0.000) and the short term effect (x2 =64.948,P =0.000) were associated with prognosis of middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Multiple-factor analysis showed that the age (RR =1.625,95 ％ CI 1.251-2.111,P=0.000),clinical staging (RR =2.437,95 ％ CI 1.874-3.168,P=0.000),concomitant with other diseases (RR =1.1.628,95 ％ CI 1.278-2.076,P =0.000) and the short term effect(RR =1.865,95 ％ CI 1.594-2.182,P =0.000) were the independent prognosis factors for middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.Conclusion Elderly patients,esophageal neoplasms in stage Ⅲ,concomitant with other diseases and poor short-term effect could influence the prognosis of the patients with middle and advanced esophageal neoplasms treated by traditional Chinese medicine combined with radiotherapy.

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P₂₅), medium (P₂₅-P₇₅) and high (>P₇₅) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P₅₀ (P₂₅-P₇₅) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.