Objective To investigate the diagnostic value and safety of medical thoracoscopy in unexplained exudative pleural effusion.Methods A retrospective analysis was conducted using the clinical data of 70 routine medical thoracoscopy examinations of unexplained exudative pleural effusion in patients.The lesions were examined pathologically under direct vision.Results White military nodules were observed under endoscopy,with multiple pro-truding nodules,focal irregular thickening of the pleura,pleural congestion,edema and adhesion.The diagnostic accu-racy of thoracoscopy was 95.7%.Among the diagnosed cases,there were 35 cases of tuberculous pleurisy,20 cases of malignant pleural effusion,8 cases of parapneumonic effusion,4 cases of pleural effusion from congestive heart failure and 3 cases of idiopathic pleural effusion,with no serious complications.Conclusion Medical thoracoscopy is a safe and accurate method in the diagnosis of unexplained exudative pleural effusion.Medical thoracoscopy is beneficial in the establishment of treatment method quickly and allows observation of the pleural lesions in pleural effusion patients using the naked eye.

Objective We studied the clinical features and its significance of coal worker's pneumoconiosis combined with sleep apnea Methods In 40 patients with coal worker's pneumoconiosis combined with sleep apnea hospitalized from February 2006 to December 2009, polysomnography ( PSG) , blood routine, urine routine, blood pressure and biochemical indicators were measured and analyzed. Results Patients with coal worker' s pneumoconiosis combined with sleep apnea manifested mainly as duplicate hypoxemia and multi-organ dysfunction: high blood pressure, dysfunction of heart, lung and kidney, increase of serum glucose, blood lipids, blood uric acid and finally led a vicious cycle to aggravate the above mentioned damage. Conclusions In clinical, multiple-organ dysfunction resulted from severe hypoxemia and hypercapnia caused by coal worker's pneumoconiosis combined with sleep apnea, should be fully aware and give ational and effective treatment early to reverse or delay the further function damages of multiple organs, and therefore significantly improve the prognosis.

Objective To investigate the correlation between ultrasonographie classification, age and lesion in female. Methods One thousand two hundred and eight patients with 2416 mammary gland were comfired by pathologic findings, including 132 benign lesion and 54 malignancy lesion. According various sonographic appearances in the mammary gland structure and involution grade, the mammary glonds were classified into glandular,fibroglandular and fatty types. A single mammary gland is statistic unit. Results To follow age growth, the proportion of glandular type was decrease, 61.7% in under 30 years of age,31.5% in 30-39 years of age,15.3% in 40-49 years of age,8.6% in 50-59 years of age,4.5 in over 60 years of age. To follow age growth, the proportion of fatty type was higher, 1.6 % in under 30 years of age, 5.80% in 30-39 years of age,5.5% in 40-49 years of age,10.8% in 50-59 years of age,38.6% in over 60 years of age. Before 60 years of age, to follow age growth, the proportion of fibroglandular type was higher, which achieved the peak value (79.2%) in 40-49 years and last to 50-59 years of age (80.6%) ,but it was decrease to 56.9% after 60 years of age. There was significant difference of the proportion in any age(P=0.000).The proportion of the benign lesion no difference in three categories. The proportion of malignancy lesion (6.23%, 16/257 mammary gland)in fatty type was higher than that in fibroglandular type (2.18%,37/1698 mammary gland) which was significant difference(P=0.000). There was no malignancy lesion in glandular type. Conclusions Significant correlation were present between uhrasonographic classification, age and malignancy lesion, no significant correlation were found between uhrasonographic classification, age and benign lesion.

OBJECTIVEThe aim of this study was to evaluate the clinical application of the thinner porcelain laminate restoration, which is initiated in the West China College of Stomatology, Sichuan University.

METHODSThe color of 51 ceramic veneers was evaluated using the chromatic instrument and visual observation.

RESULTSAmong factors affecting the clinical results of the porcelain laminate, the hue of ceramic materials and bond composites played a more important role than the dentition. The brightness of ceramic materials and bond composites were closely correlated with the whole restoration brightness. There was also a close correlation between the brightness and the bond composite.

CONCLUSIONSatisfactory restoration results can be achieved by clinical application of thinner porcelain laminate.

Objective To investigate the current situation and related risk factors of healthcare-associated infection (HAI),so as to provide evidence for making prevention and control measures of HAI.Methods On November 26, 2014,a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination,and antimicrobial application in all hospitalized patients in a tertiary first class military hospi-tal.Results A total of 1 657 hospitalized patients were investigated,66 patients developed 71 times of HAI,HAI rate and HAI case rate were 3.98% and 4.28% respectively.The top 4 departments with HAI prevalence rates were departments of neurosurgery (24.49%),hematology(19.05%),cadre ward(13.73%),and burn surgery (10.91 %).The top 5 HAI sites were lower respiratory tract (40.85%),urinary tract(23.94%),upper respirato-ry tract(12.68%),surgical site(9.86%),and gastrointestinal tract(5.63%).Of 66 cases of HAI,39 (59.09%) patients sent specimens for culture,a total of 48 pathogens were cultured,the major isolated bacteria was Esche-richia coli (n = 10,20.84%),followed by Staphylococcus aureus ,Klebsiella pneumoniae ,and Pseudomonas aeruginosa ,each was 7 (14.58 %)respectively.The usage rate of antimicrobial agents was 34.40%,specimen de-tection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%.Risk factors for HAI were age <2 years old or >60 years,with respirator,tracheotomy,urinary tract catheterization, arteriovenous catheterization,hemodialysis,and surgery,difference was significant(all P <0.05).Conclusion Mo-nitoring on key departments and key sites of HAI should be strengthened,antimicrobial agents should be used rationally based on pathogenic detection results,specimen pathogenic detection rate should be improved,and effective prevention and control measures needs to be taken according to the risk factors of HAI.

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods From March 2005 to March 2010,26 patients with Hawkins Ⅲ talus neck fracture were treated and 21 of them were followed,including 13 males and 8 females,with an average age of 37.6 years.The fractures occurred on the left side in 11 patients and on the right side in 10patients.The mechanism of injury included high falling injury in 13 patients,traffic accident injury in 7 patients and rolling down injury in 1 patient.Five cases were closed fractures and 6 cases were open fractures.A bilateral approach,the medial and lateral approaches,was used to perform the operation with cannulated screw fixation in emergency.After external fixation in functional position for 6 weeks without loading,ankle joints were allowed to take exercise with hinge brace and to bear partially basing on plain radiograph 12-16weeks later.The weight-bearing should be adjusted with follow-up.Functional results were assessed according to AOFAS (American Orthupaedic Foot and Ankle Society,AOFAS)score.Results The average duration of follow-up was 36.6 months (range,6-60 months).All fractures gained union and the average union time was 4.5 months.The average AOFAS score was 78.6.There were 4 cases in excellent results,10 in good,5 in fair and 2 in poor.The overall excellent and good rate was 67.8％.Traumatic arthritis occurred in 13 cases and avascular necrosis in 5 cases.Conclusion The effect of surgical treatment for Hawkins Ⅲtalus neck fracture via a bilateral approach is satisfactory.

Objective To investigate the risk factors of surgical site infection in patients with colorectal cancer.Methods Clinical data of 542 patients with colorectal cancer were retrospectively studied.According to the infection of surgical site or not,all patients were assigned into infection group (n =48) or non-infection group (n =494).The risk factors of surgical site infection were analyzed.Results Compared with non-infection group,the patients in the infection group got significant increase in age [(67.74 ± 9.46) years vs.(57.63 ± 9.94) years,t =7.593,P =0.000],significantly higher rate of diabetes (25.00％ vs.8.70％,x2 =12.843,P =0.000),significantly x higher rate of open surgery (70.83％ vs.33.81％,x2 =25.946,P =0.000),and significantly longer operation duration [(123.45 ± 23.56) min vs.(110.47 ± 19.47) min,t =10.485,P =0.000].Logistic study showed that age,diabetes,open surgery and operation duration were risk factors for the development of surgical site infection (all P ＜ 0.05).Conclusion Age,diabetes,open surgery and operation duration are risk factors for the development of surgical site infection in colorectal cancer.

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.

Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.