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.

Objectiye To reveal epidemiology of malignant tumor in Quanzhou area of Fujian province. Methods Medical record of adults who received health check-up between 2006 and 2010 was collected to estimate the incidence of malignant tumor. Chi-square test was used for data analyses.Results Nearly 12 323 individuals received an annual health check-up during 2006 and 2010,177 of whom were found to have malignant tumors. The identification rate of malignant tumors was 2. 87‰ per year, and the most commonly seen cancer included liver cancer ( 42. 93% ), lung cancer ( 20. 90% ), oesophageal cancer (9. 03% ), cervical cancer ( 8.47% ) and gastric cancer (6. 78% ). Those of 60 to 70 years old showed the highest incidence of cancer. Conclusion Annual health check-up may be helpful to identify early-stage malignant tumors.

Objective To observe the effects of Dong's Extraordinary Acupoints acupuncture and rehabilitation on upper limb spastic hemiplegia after stroke. Methods 105 patients with upper limb spastic hemiplegia after stroke were randomized into 3 groups as groups A, B, C equally, and receiving Baclofen and rehabilitation training, acupuncture at Dong's Extraordinary Acupoints, and both acupuncture at Dong's Extraordinary Acupoints and rehabilitation training for 8 weeks, respectively. They were assessed with China Stroke Scale (CSS) and modified Ashworth Scale (MAS) before and after treatment Results The CSS and MAS scores obviously improved after treatment in each group (P<0.01), and improved more in the group C than in the group A and B for CSS (P<0.05). Conclusion Both acupuncture at Dong's Extraordinary Acupoints and rehabilitation can improve the neural function and upper limb muscle tension in patients with upper limb spastic hemiplegia after stroke, with the synergistic effects.

Cell-Derived Microparticles ; Disease Progression ; Humans ; Leukemia ; pathology

Objective To analyze recent 30 years’ regularities in point selection for acupuncture treatment of Parkinson disease and provide reference for its treatment. Methods Parkinson disease, parkinsonism and acupuncture were used as key words. Recent 30 years’ Chinese literature was searched using Wanfang, CNKI, VIP and Chinese biomedical literature database. Selection of main acupoints and scalp acupuncture points, syndrome differentiation-based point selection and meridian tropism of main acupoints were metrologically studied. Results The Du meridian, the large intestine meridian and the gallbladder meridian were mainly selected for acupuncture treatment of Parkinson disease. Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) were used as main points. Chorea-tremor control area, motor area and parietotemporal anterior oblique line were often selected as main scalp acupuncture points. Fenglong (ST40), Qihai(CV6), Sanyinjiao(SP6), Yinlingquan(SP9) and Zusanli(ST36) were often used according to syndrome differentiation-based point selection. Conclusion Modern acupuncture doctors select Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) as main points, often use scalp acupuncture points and combine points mainly from the Du meridian according to syndrome differentiation in the treatment of Parkinson disease.

Colorectal cancer( CRC) has become one of the major cancer threatening residents′health all around the world, and considerable resources are needed for its prevention and control.Economics evaluation could provide the basis of decision-making for improving the allocation efficiency of health resources in the field of CRC prevention and control.This paper comprehensively reviewed the papers that have been published in the field of colorectal cancer screening,from the points of view of published time,regional economic evaluation re-search,evaluation method,the research angle,input and output measurement,model,recommend strategy.

[Abstact] Purpose To investigate the value of apparent diffusion coefficient (ADC) of diffusion weighted imaging (DW1) in the evaluation of the efficacy of treatment of nonsmall cell lung cancer (NSCLC) with tyrosine kinase inhibitor (TKI).Materials and Methods Nineteen patients with advanced NSCLC who treated with TKIs from May 2014 to December 2015 were recruited prospectively.All patients underwent CT and MRI scans three times before targeted therapy,after 1 week and 4 weeks of treatment.The tumor maximal diameter and mean ADC value at different time points were compared.The correlations between mean ADC value and tumor maximal diameter and maximum diameter change rate at different time points were analyzed.Bland-Altman analysis was performed to confirm the reproducibility of measurements.Results The ADC value after 1 week of treatment was significantly increased compared with that before treatment (t=-6.329,P＜0.05),but the change of tumor maximal diameter was not significant (P＞0.05).The ADC value was significantly increased after 4 weeks of treatment compared with that before treatment (t=-4.878,P＜0.05),and the change of tumor maximal diameter was also significant (t=7.054,P＜0.05).The negative correlation was detected between the ADC before treatment and the maximal diameter change ratio after 4 weeks of treatment (r2=-0.474,P＜0.05).In the group of responders,there was significant difference between the ADC value before treatment and 1 week after treatment (P＜0.05).There was significant difference in ADC value between the groups of responders and non-responders after 4 weeks of treatment (P＜0.05).The Bland-Altman analysis showed good reproducibility among the operators.Conclusion The ADC value after 1 week of targeted therapy is more sensitive to the change of tumor than the maximal diameter,and the ADC value before treatment has a certain value in predicting the maximum diameters of the target after 4 weeks of targeted therapy with repeatability.

Objective:To construct a recombinant eukaryotic expression vector containing gene encoding 18 000 outer membrane protein from human Helicobacter pylori(H.pylori) and be expressed in COS-7 cell,and lay the foundation for the exploiting DNA vaccine of Hp.Methods:The target genes encoding 18 000 outer membrane protein were acquired from the prokaryotic expression vector pET32a(+)/528 by XholⅠ,KpnⅠ digestion simultaneously,in the same way,the pcDNA3.1 was digested by XhoⅠ,KpnⅠ digestion simultaneously,and the objective genes and pcDNA3.1 were extracted out of agarose electrophoresis with gel kit,and connected by T4 ligase.The recombinant vector pcDNA3.1/528 was used to select and transform,meanwhile express in COS-7 cell.The expressions of recombinant eukaryotic vector in COS-7 cell were investigated by reverse transcriptive-polymerase chain reaction and Western.Results:The gene had inserted into eukaryotic vector was the target gene encoding 18 000 outer membrane protein by enzyme digestion analysis,and objective gene was amplified from COS-7 cell transfected with pcDNA3.1/528 by RT-PCR,the Western showed that recombinant eukaryotic vector could be expressed in COS-7 cell.Conclusion:The recombinant eukaryotic vector pcDNA3.1/528 was constructed and expressed in COS-7 cell successfully.The results obtained lay the foundation for research on development of H.pylori DNA vaccine.

BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL reconstruction using B-TP-B autograft, B-TP-B allograft and semitendinosus tendon graft (P > 0.05); 10° flexion limitation was found in 3 cases of B-TP-B autograft, 5° flexion limitation in 1 case of B-TP-B allograft and flexion limitation in 2 case of semitendinosus tendon graft. There was no significant difference in the ratio of knee joint flexion limitation among three groups. No synarthrophysis, wound infection, implant disrupture, screw loose, patellar fracture or vascular nerve injury was observed in three groups of patients; There were 12 cases presenting anterior knee pain in the B-TP-B autograft group and 5 cases presenting posterior knee pain in the semitendinosus tendon graft group. The difference of peal-knee pain incidence was statistically significant among three groups (P=0), the highest in B-TP-B autograft group, then semitendinosus tendon graft group and the lowest in B-TP-B allograft group. The time of post-operative fever in B-TP-B autograft group was earlier than that in the B-TP-B allograft and semitendinosus tendon graft groups (P=0). There was no significant difference between allogreft group and semitendinosus tendon autograft group (P=0.844). The rejections appeared in 4 cases of B-TP-B allograft with the manifestations of the sustained jam-like liquid outflow from tibial tunnel. After dressing, hormones or indomethacln, the rejection was healed. CONCLUSION: The arthroscopic B-TP-B autograft, B-TP-B autograft and semitendinosus tendon autograft have the same clinical curative effect in PCL reconstruction.

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.