Objective To investigate clinical effects of arthroscopic synovectomy combined with radiofrequency vaporization for the treatment of rheumatoid synovitis of the knee joint.Methods In 36 cases of rheumatoid gonarthritis with chronic synovitis of the knee joint,with simultaneous administration of regular medication,we had applied arthroscopic synovectomy combined with radiofrequency vaporization to remove the hyperplastic synovium and pannus through standard anteromedial and anterolateral approaches, and superolateral and superomedial approaches.In 21 out of 36 cases,diseased synovium in the posterior compartment was resected via additional posteromedial and posterolateral approaches.A systematic rehabilitation program was practiced 3 days after operation. Results All the 36 cases were followed for 4~26 months(mean,16 months).Clinical effects evaluation showed "excellent" in 21 cases,"good" in 13 cases,and "fair" in 2,with a total excellent-or-good rate of 94.4%(34/36).The knee joint function scores were significantly elevated from 58.6?5.3 preoperatively to 91.6?5.8 postoperatively(t=2.723,P=0.003).The Lysholm scores were significantly elevated from 42.3?3.8 preoperatively to 90.2?4.4 postoperatively(t=2.437,P=0.001).Conclusions Combined use of arthroscopic synovectomy with radiofrequency vaporization for the treatment of rheumatoid gonarthritis has advantages of minimal trauma,little blood loss,and rapid recovery of joint function.The procedure can effectively control the progression of rheumatoid arthritis and restore the knee joint function to the greatest possible extent.

Objective To evaluate the role of video-assisted thoracoscopic surgery (VATS) in the diagnosis and treatment of esophageal tuberculosis. Methods We had conducted video-assisted thoracoscopic surgery and acute pathological examinations for diagnosing and treating esophageal tuberculosis in 8 patients from June 1996 to April 2004. Results All the 8 patents were clarified as having secondary esophageal tuberculosis (Six of them had been misdiagnosed as having esophageal tumors preoperatively). A lymphoidectomy was carried out in 5 patents and a focus debridement, in 3 patents. The duration of procedure was 30~50 min (mean, 45 min). The intraoperative blood loss was 50~100 ml (mean, 80 ml). Postoperatively, pleural effusion occurred in 2 patients and wound infection took place in 1. Follow-up for 5~27 months (mean, 15 months) in 7 patients revealed a remarkable relief of dysphagia and no recurrence. Conclusions VATS in combination with acute pathological examinations is a rapid, safe, accurate and minimally invasive alternative for the diagnosis and treatment of esophageal tuberculosis.

Objective To assess the efficacy and safety of BioLiver Ⅰ bioartificial liver support system (BALSS) on the treatment of two types of acute liver failure (ALF) canine models. Methods The drug induced ALF canine model was established by multiple subcutaneous injections of acetaminophen. Another model was operated to resect 80 percent of the liver tissue. The primary hepatocytes were separated from the swine and cultured within the BALSS. The ALF models were treated by BioLiver ⅠBALSS for 6 hours. The changes of physiological, biochemical and histological parameters were observed before and after the treatment. Results The canines developed ALF 48 hours after injections of acetaminophen, the established rate of the model was 63 3%. While the other ALF canine model developed 24 hours after 80 percent liver resection and the established rate was 84 2%. Using our modified enzymatic digestion method, the yield of hepatocytes was (1 0～3 0)?10 10 per swine with high viability. BioLiver ⅠBALSS treatment resulted in beneficial effects on blood biochemical parameters. The pathological lesions of the liver were repaired. BALSS treatment was harmless to other organs. The ALF canines in drug group survived longer than in operation group. Conclusion This type of BALSS can provide safe and efficacious liver function support in the two types of ALF canine models, and it may be as an hepaful and important therapy to ALF

Pyk2(Proline-rich tyrosine kinase 2) is an important member of focal adhesion kinase family. Pyk2 is highly ex-pressed in the central nervous system and the hematopoietic sys-tem . Pyk 2 can trigger a variety of SH 2 domain-containing pro-
teins to phosphorylate their substrates, thus it can participate in the regulations including ion channel activation, stress response, cell adhesion, cytoskeleton reorganization, vesicle transport and so on. Through the regulations above, the ability of cell migra-tion, survival, proliferation changes accordingly, suggesting that Pyk2 in many important regulatory processes may become a tar-get for clinical effects. Current drug development for Pyk2 main-
ly focuses on cancer, osteoporosis and immune response. This review illustrates the domain structure, regulatory mechanisms, potential drug targets, and the drug development of Pyk2 based on the above three fields, which will provide a theoretical basis for clinical treatment.

Objective To study the imaging findings of atypical thymoma.Methods 16 patients with atypical thymomas confirmed by pathology were involved in this study.Results In 16 cases,the all tumors appeared as soft tissue masses in anterior mediastinum,other imaging findings included lobulated sign in 12,calcification with in the tumors in 9,directly invasion to adjacent fatty tissue in 13 and mediastinum pleural and anterior chest wall in 7.The ipsilateral mediastinum pleural planting in 8,vascular involvement in 7 and pleural effusion in 6,pericardium effusion in 3 were showed.The tumors with smooth margins and clear surrounding fatty tissue were seen in 3,that were really simulating the benign thymoma.Conclusion Atypical thymoma are of certain imaging characteristics.

Glenohumeral subluxation is one of the most frequent complications in patients with post-stroke hemiplegia. This paper reviewed the recent advances in research on post-stroke Glenohumeral subluxation from the epidemiology, pathogenesis and related factors, diagnosis,treatment and so on.

Probing into the methods and techniques of physician-patient communication is important to clinic medicine and medical education. Physician- patient shared decision is one of important aspects of physician-patient communication, 80 patients with hematologic malignancies were reviewed for classification of models of medical decision making, and the methods and techniques of physician-patient shared decision were also discussed .

Chemokines play pleiotropic roles in the pathology of Alzheimer′s disease(AD),a chronic inflammatory disease of central nervous system.The neuropathological features of AD include neurofibrillary tangles,amyloid plaques,neuroinflammation,and neuronal synaptic loss.Chemokines are involved in the pathogenesis of AD by activating or regulating inflammatory cells or glial cells,playing dual key roles of the pro-and anti-inflammatory properties in AD.The levels of chemokines in serum,cerebrospinal fluid and brain tissue of AD patients are changed accordingly.This review summarizes the role of chemokines and their receptors in AD in the biological activities and unveils the changing rules,aiming to provide new strategies for clinical treatment of AD.

Objective To explore the impact of enteral nutrition (EN)support on patients with advanced cancer.Methods 83 cases with advanced cancer were selected,the patients were randomly divided into two groups, 42 cases in the observation group,41 cases in the control group.The observation group was given EN support com-bined with parenteral nutrition (PN)support,while the control group was only given the PN support.Immune function CD +4 ,CD +4 /CD +8 ,IgA,IgG,nutrition indicators [serum albumin (ALB),transferrin (TF)and 24h urea nitrogen (24hUP)]before and 10d after surgery as well as complications were compared.Results The differences of CD +4 , CD +4 /CD +8 ,IgA,IgG,ALB,TF and 24h UP between the two groups before surgery were not statistically significant (P >0.05);10d after surgery,CD +4 ,CD +4 /CD +8 ,IgA,IgG levels in the control group were (52.4 ±4.4)%,(1.8 ± 0.3)%,(2.7 ±0.3)g/L and (11.4 ±2.1)g/L,which in the observation group were (55.9 ±5.6)%,(2.1 ± 0.5)%,(2.9 ±0.5)g/L and (12.9 ±2.3)g/L,CD +4 /CD +8 ,IgA,IgG were significantly higher in the observation group(t =2.408,2.521,2.332,2.359,all P <0.05);10d after surgery,ALB,TF and 24h UP in observation group were (36.6 ±2.3)g/L,(2.9 ±0.2)g/L,and (0.7 ±0.3)g/L,which were (32.4 ±1.5)g/L,(2.2 ±0.1)g/L,and (0.4 ±0.1)g/L in the control group,the differences were statistically significant (t =7.493,15.34,4.648,P <0.05).The incidence rate of complications in the observation group was 9.5% (4 /42),which in the control group was 26.8%(11 /41),the difference was statistically significant (χ2 =4.196,P <0.05).Conclusion EN support for patients with advanced cancer is benefit for immune function improvment and nutrition improvement,and can reduce the risk of complications.

Objective To evaluate the effect of palliative care in the treatment of pain and life quality in later period tumor patients.Methods 103 patients with advanced tumors in our hospital were selected and divided into group A(51 patients) and group B(52 patients) based on the methods of treatment.The patients in group A were given conventional treatment,and the patients in group B were given palliative care program on the basis of the treat-ment in group A.The effects of the groups A and B were observed and compared.Results The pain levels of group A and B before treatment had no statistically significant difference (P>0.05).The pain level score of group B after treatment was (26.41 ±3.55)points,which was lower than (32.56 ±7.12)points in group A,and the difference was statistically significant (t=6.430,P<0.05).The difference in life quality of the two groups before treatment was not significant (P>0.05).After treatment,the life quality score of group B was (66.85 ±6.75)points,which was higher than (53.39 ±6.74)points in group A,and the difference was statistically significant (P<0.05).Conclusion It is effective for palliative care to treat the patients with advanced tumors on their pain management and quality of life, which is worthy of clinical application.