Objective To determine chest ultrasound locating treatment of paraelectronic effusion by medical thoracoscopy.Methods We chose 40 Xinxiang center hospital patients in respiratory wards from June 2012 to June 2014,who was randomly divided into two teams,one was electron-assisted Thoracoscopic surgery,the other was thoracic cavity closed drainage combination of intrapleural injection of urokinase.It was 3rd reviewed by chest ultrasound,we evaluated curative effection ac cording to the drainage effect,we statisticsed two draining days and total inpatient days,and total hospital costs.The results two teams were compared between gender,age,nutritional status,effusion volume (length x width x depth),pleural effusion conventional,biochemical,lactate dehydrogenase,adenosine deaminase,carcinoembryonic antigen,the difference was not statistically significant (P ＞ 0.05).Pleural fluid culture results were negative.Medical thoracoscopy treatment group hospitalization days,drainage time was significantly shorter than the thoracic drainage combined with pleural urokinase group,The same was the cost of hospitalization.Medical thoracoscopy poor drainage treatment group was significantly lower than the thoracic drainage combined with pleural urokinase group (P ＜ 0.05).Conclusion To the middle-large number encapsulated paraelectronic effusion,chest ultrasound locating treatment by medical thoracoscopy early can reduce the formation of empyema,reduce the formation of pleural fiberboard.It is a safe,effective and worthy of promotion treatment.

BACKGROUND:Biliary complications after liver transplantation can cause liver graft dysfunction. Ultrasound examination is one of important diagnostic methods of biliary complications after liver transplantation.
OBJECTIVE:To investigate the value of ultrasound in the diagnosis of biliary complications after liver transplantation.
METHODS:A total of 92 patients after liver transplantation, including 81 males, 11 females, aged 21-67 years;al ogenic orthotopic liver transplantation in 90 cases, partial living liver transplantation in 2 cases. Biliary reconstruction methods were end-to-end biliary anastomosis. Routine examination after liver transplantation and color Doppler ultrasound results were retrospectively analyzed. The inspection focused on whether common bile duct and intrahepatic bile duct had biliary leakage, biliary stenosis, biliary sludge or biliary calculus. Some patients underwent puncture and drainage under ultrasonographic guidance.
RESULTS AND CONCLUSION:In al the 92 patients, 14 cases were diagnosed ultrasonical y as biliary complications, including 5 cases of biliary leakage, 4 cases of biliary stenosis (2 cases of stomal stenosis and 2 cases of non-stomal stenosis), 4 cases of biliary sludge, and 1 case of biliary calculus. This study demonstrated that ultrasound characteristics could be easily recognized in liver transplantation patients with biliary complications. Ultrasound has very important clinical value in diagnosis of the biliary complications after liver transplantation.

BACKGROUND: At present, many problems deserve to be solved before clinical utilization of adipose tissue-derived mesenchymal stem cells (ADMSCs) such as complete differentiation from ADMSCs into cardiomyocytes and ADMSCs with or without specific function of cardiomyocytes. It is of significance to solve the problems including how to elevate the differentiation rate of ADMSCs into cardiomyocytes and how to elevate the homing and survival rate after transplantation for clinical utilization of stem cells.OBJECTIVE: To observe the differentiation of ADMSCs into cardiomyocytes after in vitro culture and induction.DESIGN: Randomized controlled observation.SETTING: Laboratory of Cardiology, General Hospital of Chinese PLA.MATERIALS: Adipose tissue was collected from abdominal operative patients at Department of General Surgery of General Hospital of Chinese PLA with the agreement of patients. Iscove's Modified Dulbecco's Medium (IMDM), type Ⅰ collagenase, 5-azacytidine (5-aza) and polyclonal antibody of specific anti-myocardial Troponin T (TnT) were purchased from Hyclon company, Gibco company, Sigma and Fujian Maixin Biotechnology Company, respectively.Monoclone antibodies of CD44, CD45, CD34, HLA2DR and factor-Ⅷ, Desmin, anti-α-striated muscle actin and anti-myosin heavy chain (MHC) were bought from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation. DAB stain, reverse transcription-polymerase chain reaction (RT-PCR) kit and atrial natriuretic peptide (ANP) radioimmunity kit were purchased from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation,Invitrogen and Radioimmunity Research Institute of Science and Technology Development Center of General Hospital of Chinese PLA, respectively.METHODS: The experiment was performed at the Laboratory of Cardiology, General Hospital of Chinese PLA from March 2005 to April 2006. ADMSCs were isolated and cultured by digestion and attachment culture method. The third generation of cells were determined by immunocytochemical method for surface molecule CD44, CD13, CD105, CD45,CD34, HLA-DR, factor Ⅷ and induced by addition of 5-aza into culture medium. On the 7th, 14th, 21st and 28th days, gene of GATA4 and Nkx2.5 were tested by reverse transcription-polymerase chain reaction (RT-PCR), and the concentration of atrial natriuretic polypeptide (ANP) were also examined by radioimmunoassay.MAIN OUTCOME MEASURES: Determination of cell surface marker, gene of GATA4 and Nkx2.5, and ANP concentration.and factor Ⅷ negative for the cultured cells. After induction for 7 days with 5-aza, no cells expressed Desmin,α-Sarcomeric Actin, Myocin heavy chain (MHC) and TnT, most cells were positive stained for CD44. After induction for 14 days, small amounts of cells displayed positive for Desmin,α-Sarcomeric Actin and MHC but still negative for TnT,while partial cells expressed positive CD44. After induction for 21 days, most cells were positive for Desmin,α-Sarcomeric after induction and no significant difference was found compared with that at the 7th day [(0.022±0.01) ng/L (P＞0.05].ANP concentration was respectively (7.92±0.21) and (8.12±0.50) ng/L at the 21st day and the 28th day (P＞0.05), but there was significant difference compared with that at the 7th day (P＜0.05).

Objective To investigate the protective effect of N-acetylcysteine(NAC) on the development of myocardial hypertrophy in diabetic rats induced by streptozotocin. Methods Male SD rats were randomly divided into normal control (NC), control treatment (NCT), diabetic (DM) and diabetes treatment (DMT) groups. NAC was administered at dose of 1.4～1.5g·kg~(-1)·d~(-1) to NCT and DMT groups in the drinking water for 8 weeks. At termination the rats were surgically prepared for hemodynamic measurement, such as systolic blood pressure, heart rate, the rate of left ventricle relaxation (-dp/dt) and the time to maximum relaxation (T). Subsequently, the hearts were removed to assay relative ratio of left ventricle weight versus body weight (LVW/BW) and cardiomyocyte cross sectional areas.Plasma glucose, insulin, 15-F_(2t)-isoprostane(15-F_(2t)-Isop) concentration and superoxide dismutase (SOD) activity were analyzed. Results The LVW/BW ratio and cardiomyocyte areas were significantly attenuated by NAC treatment as compared to DM group (P＜ 0.05). Increases in -dp/dt and SOD activity and the decreases in glucose, 15-F_(2t)-Isop T (P＜ 0.05) were found at the same time. Conclusions NAC can effectively prevent the development of myocardial hypertrophy and improve diastolic function in diabetic rats, which may be related to its antioxidant capacity.

The article mainly introduces the teaching content and teaching methods of medical ethics education for international students according to the investigation of their basic information,culture background,and learning background in Tianjin Medical University and Tianjin TCM University,and sets up a perfect teaching system with the international standard in order to realize internationalization of medical education.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Immunohisto-chemical S-P method was used to examine the expression of E-cadherin,Vimentin and TGF-β1 in 54 cases oral carcinoma and 10 cases of normal oral mucosa.The positive rates of the expression of E-cadherin,Vimentin and TGF-β1 were 55.6%, 33.33% and 59.3%,respectively in oral carcinoma group(vs normal oral mucosa,P <0.05).The expression of TGF-β1 was correlated with lymph node metastasis,and showed significant positive correlation with Vimentin.Epithelial-mesenchymal transition may promote inva-sion and metastasis of oral carcinoma,and TGF-β1 promotes EMT.

ObjectiveTo explore the characteristics of left ventricular myocardial function after percutaneous coronary intervention (PCI) in patients with angina pectoris of single-vessel and.multiple-vessel coronary artery disease with two-dimensional strain (2DS).MethodsTotally 63 patients with angina pectoris were divided to single-vessel coronary artery group (n=33) and multiple-vessel coronary artery group (n= 30) based on coronary angiography,and 30 healthy volunteers were enrolled as control group.The two-dimensional images were obtained before and 3 months after PCI,and two-dimensional radial strain was analyzed on GE Echo PAC system.Peak radial strain values of left ventricular basal plane,papillary muscle plane and apical plane during systole were measured.ResultsCompared to control group,left ventricular peak systolic radial strain values decreased in many segments in patients with single-vessel coronary artery group and multiple-vessel coronary artery group before and 3 months after PCI (P＜0.05).Totally 136 and 158 left ventricular ischemic segments attained to normal 3 months after PCI in single-vessel coronary artery group (136/185,73.51％) and multiplevessel coronary artery group (158/292,54.11％),respectively (P＜0.01).ConclusionThe improvements of peak systolic radial strain are significantly different between angina pectoris patients with single-vessel and multiple-vessels coronary artery disease after PCI.

Objectives To analyze the clinical and pathological characteristics of gastric submucosal tumors (GSMTs), and evaluate the safety and efficacy of endoscopic treatment for GSMTs. Methods 61 patients with GSMTs were selected from June 2014 to September 2012 by endoscopy and ultrasonography;they were all treated by endoscopic therapy; pathological examination was took in all removed tumors, the tumors which could be the gastric stromal tumor were furtherly examined by molecular biology technique of immunohistochemistry. Result In 61 cas-es, 39 cases are female patients, accounting for 63.93%;the tumors located at the stomach fund accounted for 52.46%(32/61), at the gastric corpus for 21.31%(13/61), at the gastric antrum for 11.48 %(7/61), at cardia for 14.75%(9/61); 10 cases were treated by Endoscopic submucosal dissection, 21 by endoscopic submucosal excavation, 27 by Endoscopic full-thickness resection, 3 by Submucosal tunnelling endoscopic resection; in all 61 cases, 2 were changed to laparoscopic treatment because one tumor was too big and broke the Serous and another was located at mucus Lake of gastric fund, 1 occurred postoperative bleeding and was treated by laparoscopy successfully, 1 oc-curred postoperative perforation and was treated by endoscopy successfully; after pathological and immunohisto-chemical analysis, 34 tumors were identified as gastric stromal tumor and all of them in risk classification were at very low risk, 11 were leiomyoma, 5 were lipoma, 3 were heterotopic pancreas, 5 were calcifying fibrous pseudotu-mor, 2 were inflammatory fibroid polyps, and 1 was angiomatous proliferation; gastric stromal tumor at gastric fundus account for 73.53 % (25/34), at gastric corpus for 11.76 % (4/34), at gastric antrum for 5.88 % (2/34) and at cardia for 8.82 %(3/34). Conclusion Most GSMTs are found in female and commonly lack of specific clinical symptoms;GMSTs are commonly located at gastric fund and most of them are gastric stromal tumors, vast majority of gastric stromal tumors in the risk classification are at very low risk;the endoscopic resection is a mini-invasive, safe and ef-fective treatment for GSMTs.