Objective To investigate the diagnostic value of diameter ratio of pulmonary artery or ascending aorta in chronic obstructive pulmonary disease (COPD)patients with pulmonary hypertension.Methods 60 COPD patients with secondary pulmonary hypertension were selected as the study group,then 60 cases of normal pulmonary artery pressure COPD patients were selected as the control group.By comparing the pulmonary artery and aorta diame-ter ratio rose of the two groups to judge the value slow lung disease in patients with pulmonary hypertension of the resistive prompt action.Results The MAPD and MAD ratio of the study group was significantly higher than in the control group[(1.04 ±0.01)vs (0.83 ±0.02),t =12.572,P =0.000],and pulmonary artery high pressure ratio was positively correlated with the relative coefficient of r =0.743.Conclusion MAD ratio MAPD in the diagnosis of pulmonary artery hypertension have relatively high specificity,and the risk of an exacerbation of COPD future have prompted role in helping COPD patients with pulmonary hypertension of early detection and early treatment.

cases were histologically confirmed to be patients with squamous cell carcinoma, 4 cases to be patients with adenocarcinoma. The majority of the patients received stereotatic radiotherapy on the basis of external radiation. The single dose for stereotatic radiation was 5～10Gy, once every two days, 4～8 fractions, the total dose was 26～42 Gy by using 5～6 non-coplanar stationary beams or arc radiation. The patients′ CT was checked 2～3 months after treatment, there were 8 cases of CR( 26.7%), 18 cases of PR(60%),4 case of NR (13.3%).The median survival time was 12 months and the survival of 1 year and 2 years was 84 % and 61.2% (using Kaplan-Meier methods). The total effective rate was 86.7%. The results suggested that stereotatic radiotherapy (SRT) is effective for lung cancer at palliative and radical treatment. Combined with external irradiation, it can increase the doses of target and shorten the course of treatment.

Objective To investigate the method and the effect of posterior approach low lumbar spinal nerve root sheath decompression under microendoscope (MED-Ⅱ). Methods Thirty-nine patients with low lumbar disc herniation, accompanying severe preoperative limb numbness and radiculalgia, who were found obvious edema of nerve root with adhesion during surgery, entered the study. In the course of lumbar discectomy, a self-made mini-scalpel was used for the incision and decompression of the nerve root sheath, in which a 3～5 mm longitudinal incision was made along the dorsal side of the nerve root. Results Decompression was achieved under microendoscope (MED-Ⅱ) in all the 39 patients. Limb numbness and radiculalgia subsided completely in 17 patients within 24 postoperative hours, while the symptoms trailed off within 2 weeks following the surgery in the remaining patients. The time to complete disappearance of the symptoms was 1～14 d (mean, 6 5 d). Conclusions Minimally invasive spinal nerve root sheath incision and decompression can give a prompt relief from limb numbness and radiculalgia, improving the recovery of nervous system. Lumbar spinal nerve root sheath incision and decompression under microendoscope (MED-Ⅱ) is a safe and effective procedure.

Objective To improve the successful rate of endoscopic biliary drainage. Methods The experience of biliary drainage with duodenoscope for biliary obstruction from January 1998 to September 2001 was reviewed retrospectively. Endoscopic naso -biliary drainage (ENBD) , endoscopic retrograde biliary drainage (ERBD) and endoscopic metal biliary endoprothesis (EMBE) were performed in 242 cases, 43 cases and 35 cases respectively. Results Of 320 cases with biliary obstruction, 305 received successful drainage under endoscopy and 15 cases failed. Ten cases with ENBD failed but got successful drainage after modulating the site of naso-biliary tube or reinserting another tube. For 3 cases failed with ERBD, we chose plastic stents with appropriate length for 2 cases to achieve fluent drainage and percutaneous transhepatic biliary drainage (PTBD) was managed for another case after endoscopic management failed. For 2 cases with EMBE failed, one stent couldn' t exceed the tumor stricture site and one was obstructed by tumor implantion at one month after EMBE. Either a metal stent or a plastic stent was replaced through previous prothesis in these two failed cases. Conclusions The effect of endoscopic biliary drainage for biliary obstruction is definite. Mostly the drainage failure can be avoided as early as possible by analyzing the causes and taking some corresponding measures to correct it.

Objective To evaluate the value of endoscopy in etiological diagnosis and treatment of post - cholecystectomy syndrome. Methods Three hundred and twenty - six patients with post -cholecystectomy syndrome received ERCP. To reveral the etiology of post - cholecystectomy syndrome. For those with choledocholithiasis and those with papillary inflammatory stricture EST or EPBD were given those with papillary diverticulum and SOD EPBD were given, those with papillary tumor and hepatobiliary carcinoma EMBE were given and for those with bililary stricture in middle part of bile duct, purulent cholangitis, chloedocholithiasis(stones not excluded in one time)and bile leakage ENBD were used. Results ERCP was succeeded in 315 cases(96. 6%), 24 cases had no abnormal endoscopic findings view. 191 cases of choledocholithiasis 186 were totally get rid of stone after one to three times of opretion EST or EPBD was successfully given to 39 cases of 39 had papillary inflammatory stricture. Nine had papillary diverticulum which oppressed the papillary orifice, 7 had SOD, all of them were dealt with EPBD. Sixteen had stricture in the middle portion of bile duct, 11 of which were treated with ENBD. In 6 cases of papillary tumor and 5 hepatobiliary carcinoma patients jaundice improved significantly after received EMBE. Residual stones in cholecystic duct were seen in 4 cases. In 2 cases of bile leakage after cholecystectomy, ENBD was successfully carried out to avoid another operation. Complications were noted in 15 cases(4. 8%) of them. pancreatitis 11 cases, cholangitis 3 eases and hemorrhage of upper gastrointestinal tract one ease. Conclusion ERCP can find out the defenite cause of post - cholecystectomy syndrome at early stage and take corresponding endoscopic therapeutic measures. The complications of ERCP can be avoided by skillful operator.

Objective To investigate the factors of hospitalization expense in patients with type 2 diabetes mellitus undergoing non-emergency surgery.Methods A retrospective study included diabetic (109 cases) and control (162 cases) groups.Hospitalization expense and other observation indices were compared between two groups and subgroups.The factors that contribute to hospitalization expense were analyzed with multifactor regression analysis model.Results The median hospitalization expense was 12 014.74 yuan in the diabetic group,1.24 times than that in the control group (P =0.001).Diabetic group has higher American Society of Anesthesiologists (ASA) classification,longer wound healing time,higher postoperative infection rate,and longer hospital stay (P ＜ 0.01).Multifactor analysis revealed that the significant factors that influence the hospitalization expense were ASA classification (β =0.442,P =0.000),postoperative fasting plasma glucose (β =0.204,P =0.020),and postoperative infection (β =0.204,P =0.019).No significant difference was found in postoperative infection rate and hospitalization expense between two groups,when patients had received minimally invasive surgeries (P ＞ 0.05).Conclusions Type 2 diabetes patients have higher hospitalization expense;ASA classification,postoperative fasting plasma glucose,and postoperative infection are the main influence factors.Giving priority to minimally invasive surgeries and enhancing perioperative glucose control can help to reduce hospitalization expense in patients with type 2 diabetes mellitus.

Objective To compare the clinical efficacy and safety of anemia during pregnancy of Shengxuening tablets and ferrous succinate treatment for clinical treatment in patients with anemia .Methods 212 cases of pregnancy in early pregnancy patients with anemia from March 2015 to February 2016 in our hospital,numbered according to the order of treatment, were randomly divided the patients into group A and group B,106 cases in each group,group A with Shengxuening tablets treatment, group B with ferrous succinate tablets treatment,two groups of patients were treated with the same program of diet guidance,all patients were treated for three months.Each patient was followed up to the end of delivery, and the two groups of patients before and after pregnancy treatment to the end of pregnancy anemia and pregnancy outcomes were compared.Comparison of two groups of patients before and after treatment for one,two and three months of hemoglobin (Hb) level,red blood cell count (RBC),serum ferritin (SF),total iron binding rate (TIBC) changes;finishing treatment of the two groups during the three follow-up of Hb, RBC, SF TIBC, which returned to normal levels at the time and, after three months of treatment and evaluate the clinical efficacy of the two groups were collected and compared during the treatment of adverse drug reactions of two groups were compared.Results After treatment for one,two and three months, levels of Hb,RBC and SF in two groups of patients were significantly higher than those before treatment,TIBC was lower than that before treatment (P<0.05);After treatment for one and two months,RBC,SF and Hb in group B were significantly higher than those in group A,TIBC lower than group A(P <0.05);After treatment for three months,the levels of Hb, RBC, SF and TIBC in two groups were back to normal,and there was no significant difference between the two groups.Hb, RBC,SF,TIBC index recovery time of group B was significantly shorter than the group A (P<0.05).After treatment for three months,there was no significant difference in clinical efficacy between two groups.The adverse drug reaction rate was significantly higher in the group B than in the group A during the treatment period (P<0.05).The end of the treatment to the end of pregnancy, five cases of group A were again the parallel treatment of anemia, 11 cases of group B were again anemia and pregnancy outcome in patients with treatment ,the adverse pregnancy rate in group A was higher than that of group B, the difference was statistically significant (P<0.05).Conclusion Shengxuening tablets and succinate iron treatment of early pregnancy anemia have advantages and disadvantages,clinical can consider the combined treatment of anemia in pregnancy,improve the clinical efficacy and safety.

Objective To compare cerebralspinal fluid acetylcholine (ACh) and choline (Ch) in patients with Alzheimer's disease (AD) and vascular dementia (VD), and their correlation with cognitive impairment.Methods First, dementia scales of 22 ADs, 22 VDs and 20 controls were scored using MMSE. Then the concentrations of CSF ACh and Ch in AD and VD were examined using the high-performance liquid chromatography with electrochemical detector (HPLC-ECD). Finally, the scores of MMSE and concentrations of ACh and Ch were compared. Results The ACh concentrations in AD[(10.7?5.1)nmol/L] and VD [(16.8?7.4)nmol/L] were found to be significantly lower than in controls [(34.5?9.0)nmol/L]( P =0.001), and showed a significant positive correlation with MMSE scores. The Ch concentration in AD CSF [(627.6?145.1)nmol/L] was approximately the same as in controls [(716.0?159.4)nmol/L], and showed no correlation with MMSE scores. The Ch concentration in VD CSF [(887.4?187.4)nmol/L] was significantly higher than in AD ( P =0.001) and controls ( P =0.002).Conclusion (1)The depression of ACh is correlated with cognitive impairment, suggesting ACh is an important neurotransmitters for memory. (2) VD may have a similar pathogenesis as AD. (3) The depression of AD ACh concentration and elevation of VD Ch concentration in CSF may be a role in their differentiation. (4) The application of acetylcholinesterase inhibitors is suitable for AD and VD.

Objective To study the expression of dihydrodiol dehydrogenase (DD) in prostate cancer and its significance. Methods With reference to expression of ?-actin gene,the expression level of a human dihydrodiol dehydrogenase isoform (DD2) mRNA was examined in prostate cancer tissues (11 cases) and normal prostate tissues (10 cases) by reverse transcriptive-polymerase chain reaction(RT-PCR). Quantitative determination of relevant band densities was performed using densitometry-scanning techniques. Results Strong expression of DD2 mRNA was detected in prostate cancer tissures with absorbance in the range of 0.550 to 1.018 (median,0.726),and low expression of DD2 mRNA in normal prostate tissues with absorbance in the range of 0.248 to 0.420 (median,0.333). The difference of the expression of DD2 mRNA between cancer and normal prostate was significant ( P

Objective To explore the technical feasibility and effects of ant erior cervical discectomy and interbody fusion using endoscopic technique. Metho ds A retrospective study was undertaken in 23 patients with single segmental cer vical fracture and dislocation or cervical spondylotic myelopathy. There were 14 males and 9 females with an average age of 41.5 years (range, 23 to 64). The fr acture and dislocation patients consisted of 2 cases with complete tetraplegia e ither of C3,4 or C4,5, 3 with incomplete tetraplegia of C5,6 and 2 of C4,5 free from nervous symptoms. The operative procedures included anterior cervical disce ctomy and interbody fusion with insertion of cage or/and plate fixation through an endoscopic working canal. Results All 23 cases were followed-up from 6 to 18 months. The operative incisions healed smoothly. All patients achieved interbody fusion, and no loosening or displacement of the cage and plate occurred. For th e cervical fracture and dislocation patients, by Frankel's classification, 2 cas es with complete tetraplegia showed no any improvement, 2 cases with incomplete tetraplegia improved from grade C preoperatively to grade D postoperatively, 1 c ase with incomplete tetraplegia upgrade from C to E, 2 cases without nervous sym ptoms maintained preoperative status. For cervical spondylotic myelopathy patien ts, according to Odom's scoring system, 10 cases were assessed as excellent (dis appearance of all symptoms), 5 good (alleviation of main symptoms), 1 fair (alle viation of partial symptoms). 94% patients gained excellent and good results. No complications occurred in this series. Conclusion With the improvement of the t echnique and instrument, the endoscopic procedures can be used for anterior cerv ical discectomy, interbody fusion and internal fixation. It presents microsurgic al advantages such as minimal incision, less traumatic reaction, clear intraoper ative visualization, and less postoperative discomfort comparing to traditional approach.