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.

Objective To analyze the influence of radial neck fracture on the upper limb function in older children,and to evaluate the curative effect of plate fixation in the treatment of Salter-Harris Ⅱ type of radial neck fracture.Methods The clinical data of 16 older children with radial neck fractures who treated by T plate internal fixation were retrospectively analyzed.16 cases were closed fractures,merging radial nerve injury in 1 case,3 cases of distal humerus fractures,1 case with rib fractures,fractures were Salter-Harris Ⅱ type,adopt steel plate internal fixa tion.Results 1 6 patients were followed up for 9-1 8 months.X-ray healing time was 6-9 weekson average 7.6 weeks.No malunion and no healing,no case of epiphyseal injuries.1 patient appeared steel block forearm supination.Postoperative patients with forearm pronation were greater than 90° supination were greater than 60 °.No radial nerve injury.Evaluation results were good.Conclusion Clinical treatment effect of open reduction and plate internal fixation in the treatment of older children with Salter-Harris Ⅱ type of radial neck fracture is satisfactory.Surgical treatment not only can enhance the fracture stability,but also can do the elbow joint function exercise to prevent dysfunction much earlier.

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 clinical results of posterior cruciate ligament (PCL) reconstruction by double bundle-double tunnel Y-shape of the anterior tibialis tendon allograft. Methods From March 2001 to January 2008, 47 patients underwent PCL reconstruction were included. The allogeneic adult anterior tibialis tendon was prepared into the Y-shape double bundles with the length of 130 mm; A bundle was defined as A-side; B-side was two short bundle (B1, B2 bundle). A bundle was 70 mm in length with a diameter of 10-12 mm. B1 bundle (anterolateral bundle) was 55 mm long with a diameter of 6 mm; B2 bundle(posteromedial bundle) was about 50 mm with a diameter of 6 mm. The allograft ligament was installed through the antero-medial approach. Absorbable interface screws were fixed in the tibial tunnel firstly, and then in the femoral tundles. When being fixed, anterolateral bundle was in flexion of 90°, postero-medial bundle was in 30°. Assisted exercise with knee an angle-locked walking aid had continued for 8-10 weeks. Results The average operating time were 45 min. The average follow-up time was 49.5 months. Preoperative Lachmann was positive in all cases while Lachmann was negative in 39 cases, weakly positive in 5 cases, and positive in 4 cases postoperatively. Post-operative KT-1000 testing, Lysholm score and Tegner activity levels has improved significantly compare with the pre-operative ones. Conclusion The double folded bundles of adult anterior tibialis tendon has sufficient length and diameter for posterior cruciate ligament reconstruction with power tension. The methods of ligament passing through the tunnel has improved to ease the procedure.

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.

Objective To investigate the relationship between serum cystain C,urinary neutrophil gelatinase?associated lipocalin(NGAL),uri?nary kidney injury molecule?1(KIM?1)and preeclampsia,and explore the value in predicting preeclampsia and early kidney damage. Methods A total of 30 cases of pregnant women with severe preeclampsia,30 cases of mild preeclampsia and 60 cases of healthy pregnant women admitted in the Second Hospital of Jilin University from October 2014 to July 2015 were enrolled for the study. ELISA was performed to check urinary KIM?1 and urinary NGAL,and the serum cystatin C was detected by immune turbidity method. Results KIM?1,NGAL,serum cystatin C in the preeclampsia were significantly higher than the normal control group(P<0.05). In addition,with the development of their concentrations,the progression of pre?eclampsia gradually rise;BMI,e?GFR,urine protein/creatinine ratio,KIM?1,serum scystatin C and NGAL are the risk factors for preeclampsia;uKIM?1,serum scystatin C and NGAL and combined predictors of preeclampsia are taken as the early indicators of renal injury,which sensitivity are separately 83.3%,75%,88.9%,96.8%;specificity are respectively 72.7%,70%,75.6%,86.4%. Conclusion KIM?1,serum scystatin C and NGAL may reflect the progression of renal injury in preeclampsia .Combined predictors have a higher predictive value in the early renal injury of the preeclampsia.

Objective To evaluate right ventricular(RV)function by tissue Doppler imaging(TDI)and Tei index in patmnts with coronary artery disease(CAD).Methods One hundred twenty patients who underwent coronary angiography(CAG)were enrolled.Based on clinic evidences,such as CAG,disease history,symptom,ECG,and myocardial enzymes,all patients were divided into three groups:control group,angina group and myocardial infarction(MI)group.TDl was performed on the lateral and septal tricuspid annular.RV Tei index was obtained either from the pulse-wave Doppler(PW-Tel)and from TDI(TDI-Tei).Results There were significant differences in RV PW-Tei,TDI-Tei,Ea,and Ea/Aa among three groups.PW-Tei was 0.363±0.086.0.463±0.078 and 0.569±0.066,and TDI-Tei was 0.400±0.058,0.520±0.078 and 0.628±0.059 for the control group,angina group and MI group,respectively.Ea and Ea/Aa were gradually decreased following the severity of CAD.Sa was no difference between the control group and angina group,while Sa was much lower in mvocardial infarction group than in other groups.RV PW-Tei had a good correlation with the lateral and septal TDI-Tei.The lateral and septal TDI-Tel were significant correlated with motion velocities.Conclusions TDI can be used to comprehensively evaluate RV function in patients with CAD.TDI-Tei can sensitive reflect the damage level of overall RV function in patients with different degree CAD.

BACKGROUND:Because human cells for culturing alveolar bone cell line are from alveolar bone, which is in oral cavity,and easily polluted, so laboratory study is often unsuccessful. Because the samples are from adults, so cell division index and the successful rate of culture are low.OBJECTIVE: To compare the biological characteristics of survived cell line established through passage,cryopreservation and revitalization following in vitro culturing the alveolar bone tissue obtained from normal persons and patients with chronic periodontitis accompanied with osteoporosis in aseptic operation; To compare the biological characteristics of two kinds of cells so as to provide theoretical and related experimental evidence for defect, repair and treatment of alveolar bone.DESIGN: Controlled observation.SETTING: Department of Stomatology, Beijing Chaoyang Hospital, Capital Medical University; Institute of Orthopaedics,General Hospital of Chinese PLA.MATERIALS: Alveolar bone tissue obtained from normal persons and patients with chronic periodontitis confirmed in clinic was used in aseptic operation.METHODS: Alveolar bone tissue from normal persons and chronic periodontitis accompanied with osteoporosis were cultured in vitro. In the four cell lines (H-171, H-258, 261, 262) cultured primarily, cell lines H-171 and H-258 were chosen from periodonitis patients group and normal group respectively, and stained with histochemical and immunohistochemical methods. Cell morphology was observed. Doubling time and division index of two kinds of cells were calculated with cytometry. After several circles of passage, cryopreservation and revitalization, growth and aging rule of cells were compared.MAIN OUTCOME MEASURES: Passage and biological characteristics of two groups of cell lines.RESULTS: ①In the abnormal alveolar bone group, there was one successful primary culture and cells presented short-spindle shape. There were 3 times of cryopreservation and 3 times of revitalization. Its doubling time was 53.4 hours. The average division index was about 4‰. Cells well grew after 20 times of passages. ②In the normal alveolar bone group, there were 26 cases of cell lines cultured primarily, but passage was found in only 3 cases of cell lines due to various causes. There were 10 passages and the cells presented long-spindle shape. After two circles of cryopreservation and revitalization, the survival and growth rate of cells were inferior as compared with cell line H-171.Doubling time was 65.9 hours and the average division index was 3.5‰. ③Both two kinds of cells adhered the wall, with the characteristics of osteoblasts: AKP, toluidine blue, PAS, tetracycline-labeled mineralized nodus, type Ⅰ collagen and BMP-2 immunohistochemical staining all presented positive.CONCLUSION: Both two kinds of cultured cells have the characteristics of osteoblasts. The growth speed of cell line H-171 is faster than that of cell line H-258. No obvious mutation is found in 20 passages. In the 8th generation of H-258,aging appears and growth speed becomes slow.