Objective To investigate the effect and safety of thoracic drainage by central venous catheter in critical patients with pleural effusion. Methods A prospective study was carried out,in which 46 critical patients with pleural effusion admitted to department of critical care medicine were included,and according to the types of their primary diseases to make matched pairs,and they were divided into two groups:conventional drainage control group and central venous catheter drainage observation group(each 23 cases). The drainage effect and complications were compared between the two groups,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score, quantitative pleural effusion and the counts of white blood cells(WBC)and of platelets(PLT),the levels of prothrombin time(PT),procalcitonin(PCT)and C-reactive protein(CRP),etc. were measured on the baseline and 24 hours after the operation. Results There were no significant differences in the APACHEⅡ score,quantitative pleural effusion,amount and duration of drainage,as well as the levels of WBC,PLT,PT and PCT between group control and observation(all P>0.05). The post-drainage CRP(μg/L)level in group observation was much lower than that in group control(77.26±67.20 vs. 106.13±66.23,P<0.01). There was a trend that the incidence of complication in group control was higher than that in group observation(26.1%vs. 4.3%),but the difference was not statistically significant(P>0.05). Conclusions In the comparison between the conventional drainage and thoracic drainage with central venous catheter,the therapeutic effects for treatment of critical patients with pleural effusion were similar, but the stress was milder and the incidence of complications was lower in the latter group. Therefore,the thoracic drainage with central venous catheter is a safe,effective and alternative method to substitute the conventional drainage for critical patients with pleural effusion.

Objective To investigate the Influence of FOXC1 downregulating on biological behavior of nasopharyngeal carcinoma (NPC) 5-8F cell lines. Methods Western blotting was used to detect the protein levels of FOXC1 in human immortalized nasopharyngeal cell lines NP69, nasopharyngeal carcinoma cell lines 6-10B with lower metastasis potential and nasopharyngeal carcinoma cell lines 5-8F with higher metastasis potential. siRNA was used to downregulate the expression of FOXC1 in 5-8F cell lines, and then ability of migration and invasion were observed. Results FOXC1 protein expression level in NP69 cell lines, 6-10B cell lines and 5-8F cell lines were (0.27 ± 0.04), (0.7 ± 20.06), (1.08 ± 0.05) respectively, and the difference was statistically significant (P < 0.05). Also ability of cell migration and invasion significantly weakened after FOXC1 depletion in 5-8F cell lines (P < 0.05). Conclusion FOXC1 might regulate invasion and metastasis of nasopharyngeal carcinoma through changing expression of Fibronectin and Vimentin, and FOXC1 may be an available target for molecular target therapy of nasopharyngeal carcinoma.

Objective To explore the differential expression of low molecular weight proteins in serum of ischemic stroke patients.Methods Serum samples obtained from ischemic stroke patients (n=33) and normal controls (n=39) were analyzed by Matrix Assisted Laser Desorption/ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS) and functional outcome was assessed with modified Rankin Scale (mRS). Results 55 peaks were significantly different between ischemic stroke patients and the controls (P<0.05). There were 7 peaks between 1000~2000 Da, 4 increased peaks and 3 induced peaks in serum of ischemic stroke patients. One induced peak at 1864(m/z) had highest peak intensity in controls and induced significantly in ischemic stroke patients. While induce degree of this peak didn't correlate with the NIHSS, mRS, stroke risk factors and laboratory data. Conclusion The application of this potential biomarker is not restricted to certain subgroups of ischemic stroke patients,so it may serve as one reverse direction biomarker and provide support for early diagnosis and treatment of ischemic stroke.

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

Apolipoprotein A5(ApoA5)level and other indices were determined in patients with type 2 diabetes mellitus and healthy individuals.Compared to control group,ApoA5 level in the diabetic group was lower (P

Objective To analyze the distribution and influential factors of exam results in medical students' general surgery theory course.Methods 171 medical students were selected as subjects by cluster sampling,and the distribution and influential factors of exam results were analyzed.SPSS 17.0 software was used for statistical analysis,measurement data with (-x) ± s,and normality test with Kolmogorov-Smirnov test.Those quantitative data which do not meet the normal distribution were compared with Mann-Whitney U and Kruskal-Wallis H test.Rank transformation univariate multi-factor variance of LSD (Levene test equal error variance between groups) or Tamhane method (Levene test range error variance between groups) were compared between two groups(3-4) and the influence factors of whether the grade was good was analyzed by single factor and multi factor non conditional Logistic regression model,with the test level of alpha=0.05.Results The distribution of total exam results was normal.77 score was outlier,and the scores of female students were higher than those of male students.Scores of total exam results,multiple-choice questions and essay questions in different classes were significantly different.Data from multivariate logistic regression analysis showed that male students(OR=0.212,95％CI:0.077-0.584) were unfavorable factor for good exam results,while higher scores in noun explanation (OR=12.160,95％CI:1.985-74.495),multiple-choice questions (OR=9.887,95％CI:2.997-32.617),essay questions(OR=18.323,95％CI:6.593-50.928) were favorable factors.Conclusion The cause analysis of score's outlier and sex difference should be strengthened,and the influence of examination items on score should be emphasized.

To evaluate the efficacy of a variety of lacrimal duct obstruction diseases treated by Nd: YAG laser lacrimal duct forming surgery using Meta analysis.
●METHODS: Relevant database in 1995 - 2012 and other network resources were retrieved by computer and manual, using MetaAnalyst software on the Meta analysis. Analysis of indicators: disease prevalence between men and women, the prevalence of various lacrimal duct diseases and the effective rate of Nd: YAG laser lacrimal duct forming surgery to treat a variety of lacrimal duct obstruction diseases.
●RESULTS: According to the inclusion and exclusion criteria, 38 subjects were selected, the cumulative number of patients included 4638 cases, the men combined prevalence was 23%; the women combined prevalence was 77%; lacrimal punctum occlusion combined prevalence was 6. 0%, combined treatment efficiency was 88. 1%; lacrimal canaliculus obstruction combined prevalence of 17. 9%, combined efficiency was 85. 6%;lacrimal common canaliculus obstruction combined prevalence was 14. 0%, 92. 7% of the combined effective rate; nasolacrimal duct obstruction combined prevalence of was 43. 6%, 93. 3% of the combined effective rate;chronic dacryocystitis combined prevalence was 18. 4%, 76. 6% of the combined efficiency. All study has heterogeneity. Selection of random effects model combined effect size. Model was statistically significant (P<0. 001).
●CONCLUSlON: The prevalence of lacrimal duct obstruction diseases of women are higher than men, lacrimal canaliculus obstruction in the lacrimal duct obstruction is in the lowest prevalence, nasolacrimal duct obstruction is the main type of lacrimal duct obstruction disease, Nd: YAG laser lacrimal forming surgery has slightly efficacy different in various lacrimal duct obstruction diseases.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

Objective To compare clinical Pseudomonas aeruginosa different sources of β-lactamase-resistant phenotype differences,as to provide theoretical basis for guiding clinical rational use of antibiotics.Methods Isolation of 478 strains of Pseudomonas aeruginosa were collected from clinical specimens in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2015,by VITEK 2 Compact bacteria identification and drug sensitivity analysis of advanced expert system for β-lactamase-resistant phenotype,statistical analysis of drug resistance phenotype and antibiotic resistance.Results 478 strains of Pseudomonas aeruginosa were mainly composed of phenotype 5 and phenotype 3.Sputum,drainage fluid and bile duct bile specimens of Pseudomonas aeruginosa were based on phenotype 5,accounted for 31.08％,34.71％ and 38.46％.Multiple comparison x2 were 3.893,4.071 and 5.595,There was no statistical difference between groups compare significance (P＞0.05).Urine,secretions and whole blood samples of Pseudomonas aeruginosa were phenotype 3,accounted for 34.88 ％,27.78 ％,45.45 ％;Multiple comparison x2 were 6.654,9.956 and 9.852.There was no statistical difference between groups compare significance (P＞0.05).Sputum,drainage of liquid,bile duct bile and urine,secretion,whole blood specimens respectively source of Pseudomonas aeruginosa resistant phenotype distribution of two comparative difference was statistically significant (x2 =15.056～22.050,P＜0.05).Comparing the resistance of different β-lactamase-resistant phenotypes in Pseudomonas aeruginosa isolates from different sources:the sputum specimen source in imipenem,meropenem,piperacillin and piperacillin/tazobactam had significant difference (x2 =22.225～39.025,P＜0.05).There was statistical significance in department of hepatobiliary surgery only ceftazidime and meropenem differences (x2 =21.890～22.872,P＜0.05).Conclusion The phenotypic analysis of β-lactamase-resistant phenotypes of Pseudomonas aeruginosa from different specimens was different,which provided a theoretical basis for guiding the clinical application of antibiotics and the control of nosocomial infection of Pseudomonas aeruginosa.