Purpose:Discuss the clinicat value of video-mediastinoscopy in the diagnosis and treatment of intrathoracic diseases. Methods:From Oct.2002 to Jun.2003, 58 cases were examined and treated by video-mediastinoscopy. Of these patients,48 case were examined(the examination group) and 10 cases were treated(the treatment group). In the examination group, standard mediastinoscopy was applied in 40 cases, extended mediastinoscopy was applied in 8 cases. In the treatment group,9 cases of palmar hyperhidrosis were treated by thoracic sympathectomy,1 case of pericardial liparomphalus was resected. Results:In the examination group, 47 cases obtained definite pathological diagnoses, and 5 cases had complications. In the treatment group,no complications occurred. Conclusions:Video-mediastinoscopy is a valuable procedure to clarify diagnosis and to stage lung cancer, or in the diagnosis of mediastinal mass. It can also be used in the treatment of palmar hyperhidrosis, pericardial liparomphalus and pericardial cyst.

0.05),but significantly between VEGF levels before(261?135 pg/ml) and after(679?175 pg/ml) treatment in control group(P

Adolescent ; Adult ; Child ; Congenital Abnormalities ; surgery ; Congenital Microtia ; Ear ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To evaluate the effect of the high concentration of sevoflurane wash-in in induction of anesthesia on the cardiac function in young infants.Methods ASA Ⅰ young infants,aged 28-60 days,undergoing resection of hemangioma on body surface under general anesthesia,were studied.According to the principle of randomized block design,8 blocks were designed based on the body weight (3.0-3.4 kg,3.5-3.9 g,4.0-4.4 kg,4.5-4.9 kg,5.0-5.4 kg,5.5-5.9 kg,6.0-6.4 kg,6.5-6.9 kg),with 3 infants in each block.The infants were randomly divided into 3 groups (n =8 each):anesthesia induction with 6％,7％ and 8％ sevoflurane groups (groups S1-3).In groups S1-3,the infants inhaled 6 ％,7 ％ and 8 ％ sevoflurane respectively for induction of anesthesia.Transthoracic echocardiographic examinations were performed before sevoflurane inhalation (baseline,T1) and at 4 min of sevoflurane inhalation (T2) to record the stroke volume (SV),left ventricle end-diastolic volume (LVEDV),ejection fraction (EF),stroke volume index (SI),heart rate (HR),cardiac output (CO),cardiac index (CI),peak early diastolic velocity of mitral annulus (Ea),peak late diastolic velocity of mitral annulus (Aa),peak systolic velocity of mitral annulus (Sa),and Tei index.The mitral annulus poteroseptal Ea/Aa (Ea/Aa) was calculated.Results Compared with the baseline value,SV,EF,SI,Ea/Aa and Tei index were significandy increased,HR,Sa,Ea and Aa were significantly decreased (P ＜ 0.05),and no significant change was found in LVEDV,CO and CI at 4 min of sevoflurane inhalation in groups S1-3 (P ＞ 0.05).Tei index was significantly higher in groups S2.3 than in group S1 (P ＜ 0.05).There was no significant difference in the parameters of cardiac function between group S2 and group S3 (P ＞ 0.05).Conclusion 6 ％,7 ％ and 8 ％ sevoflurane wash-in in induction of anesthesia exert no effect on the cardiac function in young infants,and the 3 concentrations can be recommended for clinical use.

Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P <0.01]. Mter treatment, the level of IL-18 was 401.14±180.78 pg/mL in post-treatment complete remission group, which was significantly lower than that of pre-treatment group(P <0.01). The level of IL-18 in non-remission group was higher than those of normal control and CR group (P<0.01);while pre-treatment group the difference was not significant (P >0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.

10.3969/j.issn.2095-4344.2013.26.002

Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.

BACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics.
OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator cuff repair, and evaluate the difference of therapeutic efficacy between two methods.
METHODS:A computer-based search was performed in the Medline (from January 2003 to February 2014), EMBASE (from January 2003 to February 2014) and Cochrane library (February 2014). According to the inclusion and exclusion criteria, al the randomized control ed studies addressing the outcome of single-row repair and double-row repair techniques were included in this meta-analysis. The methodological quality of each study was judged and a meta-analysis was conducted using Revman5.0. The preoperative and postoperative differences between the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, the re-rupture rate and the muscle strength were compared. The forest chart was used to compare the data between two groups, and the funnel plot was finished to detect the publication bias.
RESULTS AND CONCLUSION:A total of 10 randomized control ed trials (Levels I, II) were included. Meta-analysis showed that, there was no statistical y significant difference in the Constant, ASES and UCLA scores in the double-row group and the single-row group before and after treatment. In the postoperative fol ow-up, double-row group had a lower re-rupture rate and a higher abductor muscle strength than single-row group. When the rotator cuff tear was less than 3 cm, double-row group had no significant difference with the single-row suture group. While in the over 3-cm tear group, double-row group showed better results than the single-row suture group on the Constant scpre, ASES score and UCLA score. Double-row suture has a low re-rupture rate than single-row suture in rotator cuff injury, and could achieve better abduction muscle strength. There is no significant difference in the functional score between double-row suture and single-row suture in the rotator cuff tear of less than 3 cm, while in the over 3-cm tear, double-row suture could achieve better functional score.

Objective To summarize the experience of multidisciplinary consultation for prenatal fetal deformity, and to explore the mode suitable for China. Methods The Obstetrics and Gynecology Hospital of Fudan University and Children's Hospital of Fudan University established a joint multidisciplinary consultation center, including obstetrics, pediatrics, pediatric surgery, ultrasound and other departments. A total of 3 378 pregnant women visited the consultation center from July 31, 2003 to August 1, 2013. After consultation, treatment was divided into three classes:pregnancy termination, pregnancy continuation and perinatal treatment. Follow-up was made through correspondence and telephone communication. Retrospective analysis on reasons for consultation, fetal structural abnormalities of the classification system, chronological order of abnormalities, gestational weeks of diagnosis, maternal-related factors, treatment and prognosis was performed. Results (1) Reasons for consultation:Among 3 378 women undertaking prenatal multidisciplinary consultation, 3 243 (96.00%) were due to fetal factors, and 135 (4.00%) were due to maternal factors. (2) Classification of fetal structural abnormalities:Among the 3 243 cases undertaking consultation with fetal factors, fetal abnormality was found in 80.85%(2 622/3 243). The most common were neurological abnormalities(23.19%, 608/2 622), followed by urinary tract malformation (20.25%, 531/2 622) and cardiovascular malformation (15.48%, 406/2 622). These were followed by digestive system malformation, limb deformities and space-occupying lesions. There were 156 cases of multiple malformations. (3) Average gestational weeks for diagnosis of fetal deformity:The 2 622 cases of fetal deformity were diagnosed at a mean (26.7± 2.1) of gestational weeks (21.1–30.4 weeks). Urinary tract malformations were detected at (24.0±0.7) weeks, whereas digestive system malformations were detected at (28.3±2.6) weeks. (4) Induced labor:Induced labor cases accounted for 35.66% (935/2 622), among which, 92 cases were fetal intrauterine death and 843 cases were active choice. The several highest induced labor rates resulted from multiple malformations (75.64%, 118/156), abdominal wall defects (62.22%, 28/45), diaphragmatic hernia (61.54%, 24/39), cleft lip and palate (55.32%, 26/47) and cardiovascular malformations (49.51%, 201/406). For nervous system (27.80%, 169/608), urinary tract (25.80%, 137/531) and digestive system malformations (26.94%, 66/245), induced labor rates were <30%. For abdominal lesions (14.04%, 25/178) and sacrococcygeal teratoma (13.64%, 3/22), induced labor rates were<15%. (5) Continuation of pregnancy in 1 687 cases:Cesarean section was conducted in 1 046(61.94%). Neonatal death occurred in 117(6.94%).(6) Perinatal treatment:Twenty-one cases were treated during pregnancy, including thirteen cases with fetal ascites and hydrothorax treated by drainage, five cases with fetal anemia treated by intrauterine transfusion and three cases with fetal tachycardia treated by digoxin. Ten cases were treated by ex-utero intrapartum treatment. After birth, 297 newborns immediately underwent neonatal surgery. Among these, 259 cases underwent radical surgery, eleven palliative surgery, and sixteen elective surgery after follow-up. Conclusions Prenatal multidisciplinary consultation can make comprehensive multidisciplinary assessment of fetal prognosis and improve the diagnosis and treatment of structural malformations.

Objective: To investigate and analyze the KAP situation for Uv occupational injuries in Xi′an physical education teachers and provide scientific basis for the protection .Methods:Scale and questionnaire are used to survey 1200 people , using a questionnaire method to Xi′an sports teachers′occupational injuries is ultravio-let ray KAP investigation.Results:Respondents had a history of sunburn (21.5%), worked as a certified check the skin accounts for 5.1%;Think long-term outdoor ultraviolet harm to the skin (34.1%), 58.9%take protec-tive measures, can correct understanding on the Uv 3.2%; The purpose of protective measures , 43.9% of re-spondents take measures the purpose is to prevent tanning rather than prevent sunburn .Conclusions:Physical edu-cation teachers as a special outdoor work group , the overall Uv occupational injuries protection knowledge was low , from the perspective of the biopsychosocial medical model should be based on the principle of health ethics , it should strengthen the propaganda of knowledge of Uv occupational injury protection , and actively take appropriate intervention measures .