Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

The effect of siRNA-mediated Sox4 gene silencing on Wnt/β-catenin signaling pathway of human malignant melanoma cell line A375 was investigated. Two types of dsRNA targeting Sox4 were constructed and transfected into A375 cells, and untreated cells and cells transfected with scramble RNA were used as blank control and negative control respectively. The expression levels of mRNA and protein of Sox4, Wnt3a, β-catenin and Wnt/β-catenin signaling target gene Survivin were detected after real-time PCR and Western blot respectively. MTT assay was used to measure cell proliferation after Sox4 knockdown. β-catenin/TCF transcription reporter assay was used for assessing Wnt/β-catenin signaling pathway activity. Our results showed that the two types of Sox4 siRNA were transfected into A375 cells successfully. As compared with untreated cells, Sox4 siRNAs had no significant influence on Wnt3a expression, and Sox4 siRNAs led to the decrease of β-catenin at protein level. Wnt/β-catenin signaling pathway activity was inhibited significantly. As a target of Wnt/β-catenin signaling, Survivin was decreased at both mRNA and protein levels, and cell proliferation was attenuated. Our study suggests that Sox4 may play an important role in Wnt/β-catenin signaling pathway in human malignant melanoma cells by regulating β-catenin protein level, indicating that Sox4 is involved in the progression of malignant melanoma through Wnt/β-catenin signaling pathway.

Objective To study the feasibility and effect of implantation of the biliary stent for treatment of biliary obstruction.Methods A retrospective analysis of the diagnostic and therapeutic procedure was done in 131 cases of the inpatients from Apr.2006 to Feb.2007.The 131 patients with biliary obstruction underwent successfully 138 cases/times implantation of biliary stent.The results of recession of jaudince and the rate of complication were evaluated.Results All patients were implanted biliary stent successfully.The serum total bilirubin,direct bilirubin,alkaline phosphatase,?-glutamyl transpeptidase decreased obviously in three days,and the difference was remarkable.The main complication was infection of biliary tract and pancreatitis.Conclusion Implantation of biliary stent is an effective management for biliary obstruction,especially for patients who have lost the chance of operation.

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.

Objective To investigate the diagnostic value of coding gene of Sj26, Sj32 and Sj14-3-3 amplified by PCR for chronic Schistosomiasis japonica. Methods The DNA was extracted from sera of 40 patients with chronic Schistosomiasis japonica, the coding gene of Sj26, Sj32 and Sj14-3-3 was amplified by PCR and identified by 1.2% agarose gel electrophoresis. DNA from the sera of 21 patients with Clonorchiasis sinensis, 13 patients with Parogonimiasis westermani and 43 healthy donors was taken as control. Results A total of 399 bp coding gene of Sj14-3-3 was amplified successfully from sera of the patients with chronic Schistosomiasis japonica,but Sj26(676 bp) and Sj32( 1270 bp) coding gene were not obtained. Control groups were all negative. Conclusions Sj14-3-3 coding gene amplified by PCR can be used for genetic diagnosis of chronic schistosomiasis.

Objective To study the diagnostic value of rSj26-Sj32-IgG-ELISA for acute schistosomiasis japonica. Methods Purified rSj26-Sj32 fusion protein and crude Schistosoma japonicum antigen (SjAWA)were used to establish IgG-ELISA to detect serum of patients with acute schistosomiasis, and clonorchiasis sinensis,paragonimiasis westermani, alveolar echinococcosis, cystic echinococcosis, type B hepatitis, lung tuberculosis patients and healthy human serum were used as control. Results The sensitivity and specialty were 90.00%(45/50) ,97.67% (42/43) and 92.00% (46/50),97.67% (42/43) in detection of acute schistosomiasis japonica with rSj26-Sj32and SjAWA, respectively, and the difference was not statistically significant(x2 were both 0.0, all P ＞0.05). The serum cross-reaction reactivity was 20.00%(2/10) in patients with alveolar echinococcosis with SjAWA,but no cross-reaction with rSj26-Sj32, the difference was not statistically significant(x2 = 0.5, P ＞ 0.05). The serum cross-reactivity were 14.29% (3/21 ), 7.69% (1/13) and 19.05% (4/21 ), 7.69% (1/13) among patients with clonorchiasis sinensis and paragonimiasis westermani by rSj26-Sj32 and SjAWA, but no cross reaction with type B hepatitis and lung tuberculosis patients, the difference was not statistically significant (x2 were both 0.0, all P ＞ 0.05). The positive predictive value, the negative predictive value and the diagnostic efficiency with acute schistosomiasis japonicum by rSj26-Sj32-IgG-ELISA and SjAWA-IgG-ELISA were 97.83% (45/46),89.36% (42/47),93.55% (87/93)and 97.87% (46/47),91.30% (42/46),94.62% (88/93), respectively, and the difference was not statistically significant (x2 were both 0.0, all P ＞ 0.05). Conclusion rSj26-Sj32 fusion protein can be used for the immune diagnosis of acute schistosomiasis japonica.

?AIM: To evaluate the clinical effects, corneal surface shape and corneal thickness variation after treated by Danzhi Xiaoyao Capsule combined with hypromellose 2910, dextran 70 and glycerol eye drops for dry eye in menopausal patients.?METHODS: Eighty menopausal patients ( 160 eyes ) diagnosed as dry eye were randomly divided into groups A and B ( 40 patients each ) . Group A was treated with hypromellose 2910,dextran 70 and glycerol eye drops only and group B was treated with Danzhi Xiaoyao Capsule and eye drops. Before and 1mo after treatment, the clinical effects were evaluated by symptom scores, fluorescein staining ( FL ) , tear film breakup time ( BUT ) and Schirmer Ⅰ test. While the corneal surface regularity index (SRI), surface asymmetry index (SAI) and central corneal thickness ( CCT) were observed.? RESULTS: At 1mo after treatment, the symptoms scores and FL scores of the 2 groups decreased significantly( P<0. 05 ); BUT and SⅠt were significantly increased (P<0. 05). SRI and SAI gradually increased with dry eye exacerbations, after treatment the two parameters significantly reduced than those before treatment. SRI of group B improved significantly more than group A. CCT gradually got thinning with the dry eye condition worsened, which also significantly increased after treatment (P<0. 05);but there was no difference between 2 groups before and after treatment(P>0. 05).?CONCLUSION: Combination therapy of Danzhi Xiaoyao Capsule and hypromellose 2910, dextran 70 and glycerol eye drops for menopausal patients with dry eye is more effective than single eye drops, and can improve the symptoms and signs.

Objective To investigate the factors for retinopathy in premature infants. Methods Ophthalmologic mydri was conducted in premature infants and acording to the international classification of ROP, they were diagnosed as ROP. The risk factors of the incidence of ROP were statistically and respectively analyzed. Results Among total of 47 patients, 11 patients were found retinopathy of prematurity. Conclusion The body weight is lower, the gestation is shorter, incidence of ROP is the higher.

Objective To investigate the risk factors of pulmonary fungal infection in intensive care unit(ICU),and discuss the strategy of prevention and treatment.Methods Forty children with pulmonary fungal infection in ICU of Wuhan Children's Hospital from Jan.2003 to Jan.2007 were analyzed retrospectively,including primarily diseases,application of antibiotics,adrenal cortical hormone and virulence operation,therapy and turnover.Results All children were accepted the therapies of broad spectrum antibiotics and glucocorticoids for long time before definite diagnosis of pulmonary fungal infection.Seventy-five percent children were received invasive operations or therapies.Their average time of stayed in hospital was 37.8 d.The clinical symptoms and imaging examinations were untypical.Blastomyces albicans was the main pathogen.After the antifungal agents and supportive treatment used in time,35 cases(87.5%) were cured and 5 cases(12.5%) died.Conclusions The major risk factors of children pulmonary fungal infection are long-time use of broad spectrum antibiotics and glucocorticoids.The pulmonary fungal infection can decrease by rational use of broad spectrum antibiotics and glucocorticoids,decreasing the unnecessary invasive operations,strengthening the supportive therapies of micro-ecosystem,and applying the antifungal agents in time.

One hundred patients with Parkinson's disease (PD) aged 60 and above treated with levodopa were enrolled in this cross section study.The general conditions,medication,unified Parkinson's disease rating scale (UPDRS) scores and the incidence of levodopa-induced dyskinesia (LID) were documented.The incidence rate of LID in this group of PD patients was 37.0％ (37/100).The incidence was significantly higher in patients with levodopa treatment ≥ 4 years than that in patients with levodopa treatment ＜ 4 years (55％ vs.26％,x2 =8.770,P =0.003).The incidence rate ofpeak dosage dyskinesia in tremor-dominant PD patients was lower than that in rigidity-dominant PD patients(x2 =4.399,P =0.036).The incidence rate of LID was correlated with the duration of levodopa therapy.Amantadine may reduce the incidence of off dystonia.