Objective To understand the clinical characteristics of primary small vessel vasculitis with involvement of lungs in children and analyze the causes of misdiagnosis.Methods Clinical data from 16 patients with primary small vessel vasculitis were collected and their pathological,antineutrophil cytoplasmic antibody(ANCA),pulmonary lesion manifestations,image and misdiagnosis were further analyzed.Results Among 16 cases,9 cases were microscopic polyarateritis(MPA) and 4 cases were Wegeners granulomatosis(WG) and 3 cases were Churg-Strause syndrome(CSS).The ages of onset were from 3 to 14 years old with average age of 7.5 years old.Seventy-five percent(12/16) were ANCA positive.The patients with lung involvement had cough,chest pain,dyspnea,hemoptasis and asthma.Findings on lung X-ray films were variable.Some showed multiple patch shadows,others showed single or multiple masses or nodular shadows with or without cavity formation.After the treatments with corticosteroid and cyclophosphamide,10 cases turned better;including 8 cases with normal on lung X-ray films.Three cases given up;3 cases died.Conclusion It is very difficult to make diagnosis of primary small vessel vasculitis with involvement of lungs and should be paid more attentions to this issue.

Objective:To compare the pharmacokinetics consistence of baicalin between traditional slice decoction and dispensing granule decoction of Huanglianjiedu decoction. Methods:After the gastric administration of the two decoctions at low, middle and high dose in rats, an HPLC method was used to detect the content of baicalin in the plasma, and then DASS 2. 1. 1 software was used to cal-culate the pharmacokinetic parameters. Results:After the administration of the two decoctions at low, middle and high dose, the phar-macokinetic parameters were as follows:Cmax of 0. 25 and 0. 27μg·ml-1 ,0. 30 and 0. 31 μg·ml-1 ,0. 40 and 0. 45 μg·ml-1;AUC of 2. 48 and 2. 59μg·ml-1 ·h,3. 59 and 3. 71μg·ml-1 ·h,5. 71 and 6. 16μg·ml-1 ·h;Tmax of 3. 0 and 3. 0 h,3. 0 and 3. 0 h, 4.0 and 4.0 h;Vd of (2 822.4 ±118.2) and (2 998.9 ±255.6) L·kg-1,(3 102.6 ±176.3) and (3 405.3 ±213.8) L·kg-1, (4 231.2 ±155.4) and (4 486.0 ±187.0) L·kg-1;CL of (2 923.3 ±215.6) and (2 767.5 ±184.6)L·h-1·kg-1,(4 921.7 ± 225.4) and (4 040.8 ±246.7)L·h-1·kg-1,(5 255.9 ±189.7) and (4 868.7 ±260.4)L·h-1·kg-1;and t1/2 of (3.88 ± 0.41) and (3.71 ±0.37)h,(4.19 ±0.36) and (3.73 ±0.51)h, (5.54 ±0.38) and (5.80 ±0.54)h. Conclusion: The pharma-cokinetic parameters of baicalin have no significant difference between traditional slice decoction and dispensing granule decoction of Huanglianjiedu decoction.

Objective To explore the dosimetry of simplified intensity modulated radiotherapy (sIMRT)in the spinal component of craniospinal irradiation(CSI)compared with conventional plan(3D-CRT).Methods Five previously treated patients were adopted to generate 3D-CRT,3-and 5-field slMRT plans.The prescribed dose was 36 Gy to the planning target volume(PTV)in 20 fractions.The dose distributions of target volume and normal tissues,and homogeneity index(HI)were ananlyzed using the dose volume histogram.The total monitor units(MUs)were also analyzed to compare the delivery time indirectly.Results For 3D-CRT plans,the region of the neighbouring fields only received 70％ of the prescribed dose,and the maximum dose delivered in the normal tissues was increased to approximately 140％ of the prescribed dose.The homogeneity index(HI)of 3-and 5-field sIMRT were 0.09 ± 0.01 and 0.08 ±0.01,respectively,superior to that of 3D-CRT(0.18 ± 0.02,t=7.80,7.65,P＜0.05).The values of V10 for the heart of 3-and 5-field sIMRT were(8.4 ± 1.9)％ and(8.4 ± 2.0)％,respectively,lower than that of 3D-CRT((36.0 ± 6.0)％(t=13.3,13.0,P＜0.05).V20 for the thyroid gland were (12.4±1.5)％ and(12.4±1.6)％,respectively,lower than(69.4±5.7)％ of 3D-CRT(t=26.3,26.4,P＜0.05).V20 for the larynx were(17.2 ± 1.2)％ and(17.9 ± 1.5)％,respectively,lower than that of 3D-CRT[(89.4±7.0)％(t=25.5,26.5,P＜0.05)].V30for the NTwas(4.4±1.4)％,(4.9± 1.9)％,lower than that of 3 D-CRT[(31.9 ± 6.1)％(t=8.5,10.1,P＜0.05)].The averaged values of total MUs for 3-and 5-field sIMRT were 1100 ± 177 and 1160 ±204,respectively,higher than that of 3D-CRT(640 ± 151).Conclusions Compared with the 3D-CRT CSI technique,3-and 5-field sIMRT have better dose distribution and can improve target dose uniformity and protect the organs at risk.

Objective To investigate the difference of curative effects between the complete video assisted thoracic surgery (C-VATS)and traditional open surgery in the treatment of elderly patients with lung cancer,and to clarify the specially curative effect of C-VATS.Methods 80 patients with lung cancer without diabetes mellitus,chronic brouchitis and heart diseases aged over 65 years were enrolled in the study.They were divided into C-VATS group and open surgery for lobectomy (OPEN)group (n=40)according their wishes.The operation time,number of lymph nodes removed,amount of intraoperative blood loss,postoperative thoracic drainage,chest tube duration, postoperative hospitalized time, postoperative pain degree, incidence of postoperative complications, preoperative and postoperative sedentary heart rate (HR)of the patients in two groups were compared.Results The operation time in C-VATS group(193.12 min±59.06 min)was longer than that in OPEN group(167.17 min±54.01 min) (P<0.05),and the number of lymph nodes removed in C-VATS group(14.6±7.5)had no significant difference compared with OPEN group(15.2 ± 4.5)(P>0.05).The postoperative pain degree in C-VATS group(2.54 ± 0.12)was lower than that in OPEN group(4.61 ± 0.10)(P<0.05);the postoperative chest rube duration in C-VAS group(6.14 d ± 3.32 d)was short than that in OPEN group (11.67 d ± 4.13 d);the postperative hospitalized time in C-AVA group(8.52 d±3.25 d)was shorter than that in OPEN group (14.76 d±6.11 d)(P<0.05).There were no significant differences of intraoperative blood loss(231.28 mL±203.15 mL vs 213.33 mL± 187.18 mL),postoperative thoracic draginage(1 597.83 mL± 1 049.29 mL vs 1 690.68 mL± 1 043.37 mL), incidence of postoperative complications between C-VATS group and OPEN group(P>0.05).The postoperative sedentary HR in C-VATS group and OPEN group were significantly higher than preoperative;the postoperative sedentary HR recovered to the preoperative level 3 d after operation in C-VATS group and it recovered to the preoperative level 7 d after operation in OPEN group. Conclusion Compared with traditional open thoracic surgery, C-VATS owns the characteristics such as less trauma, less pain, less hospital stay and better postoperative recovery in the aged patients with lung cancer.

Objective To investigate the effects of 7 5% hypertonic saline (HS) on fluid balance after elective major abdominal surgery Methods Twenty two patients undergoing elective major abdominal surgery were assigned to receive either Ringer lactate solution followed by 4 ml/kg of 7 5% HS (study group, n =11) or Ringer lactate solution (control group, n =11) during the early postoperative period in ICU We compared fluid infusion volumes and urine outputs, fluid balance, and body weight change between the 2 groups Results Urine outputs in the operative day and the first postoperative day in study group were significantly more than in control group [(2?650?531)ml vs (2?046?572)ml, t =2 551?7, P

Objective To make a comprehensive evaluation of nano-composite of poly(L-lactide) and surface grafted hydroxyapatite(PLLA/PLLA-gHA) as a new material.Methods According to the evaluated critera of medical implanted materials biology and animal trial recommended in GB/T 16886 and IS0 10993 criterion,the new material was carried out on acute systemic toxicity test,haemolysis test,muscular implantation test and subcutaneous injection test.The extract liquid of new material was injected into mice by vena caudalis to test common station,toxic reaction of it at different time,the results were used to evaluate the acute systemic toxicity.Fresh anticoagulant cony blood was mixed with extract liquid of new material with density of 100 g?L-1 to measure each absorbance with spectrophotometer and work out the corresponding rate of haemolysis.The red punctuation and hydropsia of rabbits were observed at different time by subcuntaneous injecting extract liquid into the back of rabbits.PLLA/PLLA-gHA composite plates were implanted into the sacrospinal muscle of rabbits.Cony venous blood was extracted to detect indicatrix of hematology at diferrent time.The material and surrounded tissues were taken out from animals at the 14th,30th,60th,90th,180th,360th day to examine anatomic and pathological changes.Results Rabbits with PLLA/PLLA-gHA composite had good general condition.There was no any acute systemic toxicity in vivo.Data of AST and Scr had no significant difference between experimental group and control group.The hemolysis rate of extrac liquid was 1.22%,which was under the standard criteria(5%).No red punctuation and light hydropsia were observed at different time in the subcutaneous injection test.The inflammation cytochange of PLLA/PLLA-gHA composite group was similar with that of control group in early days,which was met with the general regularity of inflammatory outcome.The fibrosis membrane surrounding the PLLA/PLLA-gHA composite became thinner gradually with the elongation of implantation time.The fibrosis membrane grew into the material at the 360th day.The degree of the fibrosis membrane was below class Ⅰ.Conclusion The new absorbable type PLLA/PLLA-gHA composite has excellent biocompatibility and security.

Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P＜0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P＞0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P ＜ 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P＞0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm.

Objective To compare two verification tools for intensity modulated radiotherapy (IM-RT) and to investigate the feasibility of a new three dimensitional verification tool. Methods Five patients receiving IMRT were randomly chosen for the quality assurance plans with MapCHECK Model 1175 (SunNu-clear, Melbourne, FL,USA) and Delta4(ScandiDos, Sweden) by using Philips Pinnacle 8.0D treatment planning system. Dose verification was measured with the Varian Clinical 23EX LA. Results The overall average percentages of pass points in DD2% DTA2 mm, DD3% DTA3 mm and DD4% DTA4 mm were 84.7%, 97. 1% and 99.3% with MapCHECK Model 1175, 86.2%, 98.2% and 99.6% with Delta4 re-spectively. The differences were statisticically significant (t = 3.94, P = 0.003 ; t = 3.17, P = 0.011 ; t = 3.05 ,P =0.014,respectively). The gantry angle was changed to zero degree with MapCHECK, but not with Delta. The effects were embodied with Delta, such as the gravity on leaf position accuracy of MLC, the treat-ment table on dose distribution and the earth magnetism on dose system. Conclusion Delta4 is an ideal verification tool for intensity modulated radiotherapy.

Objective To investigate the correlation between dyslipidemia and important organ damage in patients with active systemic lupus erythematosus (SLE) without treatment. Methods Serum sam-ples from 71 active SLE patients and 30 healthy controls were obtained to measure lipid profiles including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), apolipoproteinA1 (apoA1), apolipoproteinB100 (apoB) and lipoprotein a (LPa). Clinical parameters were recorded. Results The levels of serum TC, TG, LDL, apoB in active SLE patients were higher than those in healthy controls, in contrast,the levels of HDL,apoA1 were much lower (P<0.05 or P<0.01). Patients with important organ damages had longer disease course and elevated levels of serum TC, TG, LDL and apoB concentrations than those without organ damage (P<0.05 or P<0.01), especially in patients with cadiovascular diseases (CVD) (P<0.01). Moreover, these changes in lipid metabolism were positively correl-ated with disease course and negatively with C3 level (P<0.05 or P<0.01). The elevated serum TC and LDL concentrations were negatively correlated with C4 level (P<0.05). Conclusion Severe dyslipidemia is present in active SLE patients.It is correlated with disease course and disease activity. Increased serum TC, TG, LDL and apoB concentrations play key roles in patients with important organ damages.

Objective To investigate abnormal glucose metablism of patients with stroke in hospital in Foshan in order to design more reasonable diagnostic and treatment plans.Methods Our study was conducted in 557 patients with stroke who were in hospital in Neurology Department of the First Hospital of Foshan from June 2007 to April 2008 (all were consistent with diagnostic criteria of stroke).Sex,age,history of diabetes mellitus and smoking,height,weight,blood pressure,waist circumference,random blood glucose,fasting blood glucose and oral glucose tolerance test of all were recorded when they were in hospital Results All 368 individuals (66.1%) had abnormal blood glucose,including 185 cases (33.2%) of diabetes,183 cases (32.9%) of impaired glucose tolerance and 189 cases (33.9%) of normal sugar tolerance.Furthermore,about 89.1% (189/368) cases with impaired glucose regulation and 14.1% (26/185) cases of diabetes were misdiagnosed if they did not undergo oral glucose tolerance test.Conclusions Most of patients with stroke in Foshan have impaired glucose regulation,who have been diagnosed by oral glucose tolerance test,in favour of us to better design more reasonable diagnostic and treatment plans.