Objective To evaluated the efficacy of lentinan injection and carboplatin for malignant pleural effusions.Methods 63 patients were divided into the experimental group and control group.The experimental group were adminstered lentinan injection and carboplatin.Results The response rate of the experimental group was 81.2%,the control group was 61.3%.The better quality of life appeared in the experimental group.Conclusion Postoperative lentinan injection and carboplatin in formalignant pleural effusions is a beneficial therapeusis that helps to improve survival rates and qulity of life.

Objective To study transthoracic photograph for shoulder joint with DR. Methods The advantages and disadvantages of three photography methods were discussed and analyzed. Results DR dual-detector and post-processing did good to transthoracic photograph. Conclusion Transthoracic photograph for shoulder joint at non-conventional positions is very significant.

The angle of tibial torsion is an inherent angle in human bodies.The angle has been to knew of clinical workers.But the research of mechanism for angle of tibial torsion and relationship with some disease still in initial stage.Recent years,the angle of tibial torsion has been noticed with the concept of torsionaldeform appearance.This paper summarizes measurement of the angle of tibial torsion andits advancement of correlated research.

Objective To analyze the clinical,radiologic and pathological features of endobronchial metastasis from prostate cancer, and its diagnosis and treatment. Methods Ten cases of endobronchial metastasis from prostate cancer with pathological evidence in our hospital were retrospectively analyzed.The clinical, radiologie andpathological features and the diagnostic procedures and treatment of the cases were reported and analyzed while combined with literature. ResultsAn average age at diagnosis of advanced prostate cancer was 65.5 years. Emoptysis(5/10), cough (4/10), dyspnea (4/10) and weight loss (5/10) were the common symptoms.Chest X-ray disclosed hilar and mediastinal lymphadenopathy (4/10), hilar mass (3/10) or atelectasis (2/10) . Bronchoscopic examination revealed that most of lesion located in single lobar or segmental bronchus (6/10). Bilateral upper lobe were most susceptibly involved(7/10). Polypoid lesions or mass in lumen of bronchi(8/10)were more frequent than infiltrative lesion(2/10), which could obstruct the orifice of the bronchi in different extent. Immunohistochemical staining for prostate specific antigen or prostatic acid phosphatase was positive, and most patients responded well to endocrine therapy. Conclusions Clin.ical and radiologic features of endobronchial metastasis from prostate cancer are similar to those of primary bronchogenic carcinoma. Immunohistoehemical study is helpful for differential diagnosis and the short-term efficacy of endocrine therapy is significant.

Objective To analyze and compare the clinical features of community-acquired pneumonia caused by Legionella in elderly (age≥60 years) and younger patients. Methods The epidemiological, clinical, laboratory data and the outcomes of 80 cases with community-acquired Legionella pneumonia (CALP) from January 2001 to October 2009 were studied retrospectively, and the differences between elderly and younger group were compared using univariate and multivariate analysis. Results (1) Underlying diseases, such as cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus and immunosuppressive therapy were significantly more frequent in elderly group than in younger group (all P＜0. 05). (2) No significant differences were observed between the two groups in legionella serotype. (3) Malaise, hyponatremia and hypophosphatemia were all more frequent in elderly group than in younger group (x2=5. 300, 5. 520, 4. 470; P=0. 021,0. 019, 0. 034, respectively). And elderly versus younger group had higher creatinine levels [(108.55±56.57) μmmol/L vs. (75.42±17.62) μmmol/L, t= -3. 062, P=0. 002], lower PaO2/FiO2 (＜300) (57.7% vs. 29.2%, x2=4. 120, P=0.042), less leucocyte counts [(8.34±3.65)×109/Lvs. (10.63±5.02)×109/L, t=-2.287, P=0.022]. (4) Elderly patients more likely complicated with congestive heart failure (P=0.037) and their length of staying in hospital was also longer (Z=-2.194, P=0.028). No significant differences were observed between the two groups in mortality, intensive care unit admission, and the need for corticosteroids or mechanical ventilation.Conclusions Elderly patients with CALP have a higher frequency of underlying comorbidities and more organs involvement than younger patients, although greater severity of illness at onset and outcome are not significantly different between the two groups.

Objective To describe the clinical and radiological characteristics, diagnosis, and treatment of bronchobiliary fistula (BBF). Methods From December 1975 to June 2007, 6 patients with BBF were successfully diagnosed and treated in this hospital. A retrospective analysis was performed and literatures on the disease were reviewed. Results All the cases were acquired BBF. The etiologies included liver abscess (3 cases), trauma (2 cases), and postoperative complication of hepatic carcinoma (1 case). The main symptoms the patients complained of were fever (6 cases), cough (6 cases), biliptysis (6 cases), dyspnea (4 cases), abdominal pain in right quadrant (4 cases) and pleuritic chest pain (2 cases). On physical examination, tenderness in the right upper quadrant (4 cases), dull percussion (3 cases), abnormal breath sounds (3 cases), percussion tenderness over hepatic region (2 cases) were main abnormalities. All the 6 patients underwent antibiotics treatment and percutaneous transhepatic biliary/abscess drainage. One of them underwent radiological coil embolization of the fistula. All the patients showed clinical improvement. Follow-up survey showed 1 case of cure, 1 case of long-term drainage until death of biliary tract bleeding one year later, and 4 cases of lost in follow-up. Conclusion Bronchobiliary fistula is characterized by biliptysis. Minimally invasive treatment should be the first therapeutic option.

Objective To investigate the clinical effect of continuous blood purification therapy in patients with severe heart failure and renal failure.Methods The clinical data of 38 patients with severe heart failure and renal failure treated by continuous blood purification were analyzed retrospectively.Heart rate,mean blood pressure, APACHE II score,Boston score,blood biochemistry,blood gas analysis and cardiac function changes were compared before and after the treatment of continuous blood purification.Results After treatment 12h and 72h,patients breath-ing[(19.24 ±2.88)times/min],heart rate[(88.57 ±15.68)times/min],APACHE Ⅱ [(14.28 ±3.26)points] and the score of Boston[(6.27 ±1.25 )points]were significantly decreased compared with those before treatment [(35.68 ±5.97)time /min,(131.24 ±24.26)time /min,(26.34 ±5.96)points,(17.88 ±2.87)points],and the differences were statistically significant (t =3.13 3.45,2.12,4.11,3.67,5.68,3.44,609,all P <0.05).38 cases of severe heart failure with renal failure after continuous blood purification treatment,markedly effective in 16 cases, effective in 12 cases,ineffective in 10 cases,the total effective rate was 73.68%.Patients after continuous blood purification treatment,the SCr[(168.15 ±31.16)μmol/L],BUN [(13.13 ±3.44)mmol/L]were significantly decreased.pH[(7.41 ±0.13)],HCO3 [(25.57 ±5.11)mmol/L],PaO2 [(88.26 ±7.72)mmHg],SaO2 [(96.43 ± 3.14)%]and blood biochemistry and blood gas index decreased markedly,and the differences were statistically significant (t =4.55,3.21,2.11,3.45,673,4.21,all P <0.05).After the examination of echocardiography,stroke volume (SV)[(59.31 ±6.58)mL],cardiac output (CO)[(4.57 ±0.62)L/min]and left ventricular ejection fraction (LVEF)[(68.12 ±4.88)%]increased significantly compared with before treatment,and the differences were statistically significant (t =4.33,5.12,367,all P <0.05).Conclusion Continuous blood purification could effectively maintain the hemodynamic stability of patients,and is safe and effective in the treatment of severe heart failure with renal failure.

Objective To investigate the influence of lumbar epidural anesthesia on cell apoptosis in rat kidneys with ischemia-reperfusion injury.Methods Thirty male Wistar rats were divided into three groups at random,including a sham-operated group,a model group,and an anesthesia group.Then the local norepinephrine,local angiotensin Ⅱ,plasma superoxide dismutase,plasma malondialdehyde and cell apoptosis index were observed at the 24 h after the reperfusion in rat kidneys of ischemia 60 min.Results Compared to the sham-operated group,ischemia-reperfusion of kidney caused a significant increase in contents of local norepinephrine,local angiotensin Ⅱ],and malondialdehyde in the model group and anesthesia group as well as increasing in the cell apoptosis index (P ＜ 0.05),and those parameters above were lower in the anesthesia group than those in the model group (P ＜0.05).Meanwhile,the activities of plasma superoxide were higher than those in model group (P ＜ 0.05).Conclusions The lumbar epidural anesthesia can reduce the excessive accumulation of neuroendocrine hormone in kidney,alleviate oxidative stress,which plays an important role in restraining the ischemia-reperfusion injury and cell apoptosis.

Objective To compare the effect of Zhigancao Decoction and Zhenwu Decoction on hemodynamics, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and myocardial enzyme of elderly patients with chronic heart failure.Methods 40 elderly patients with chronic heart failure in the first affiliated hospital of the medical college, Shihezi university were selected and randomly divided into Zhigancao Decoction group (n=20) and Zhenwu Decoction group (n =20) .The both of two groups were given conventional treatment, then were treated with respective drug according to different groups with two courses, one course of two weeks.The hemodynamic, MMP-9, TIMP-1 and myocardial enzyme spectrum indexes of two groups were compared post-treatment.Results After treatment, the indexes of hemodynamics in two groups were improved, hemodynamic indexes of Zhigancao Decoction recovered better than those of Zhenwu Decoction (P<0.05) .The serum MMP-9, MMP-9/TIMP-1 of Zhigancao Decoction group were lower and TIMP-1 was higher than those of Zhenwu Decoction group (P<0.05).The myocardial enzyme indexes in both groups were lower post-treatment, and the above indexes in Zhigancao Decoction were lower than those in Zhenwu Decoction group (P<0.05) . Conclusion Zhigancao Decoction could obviously improve the symptoms of chronic heart failure in elderly patients, which has the guiding significant in the clinical treatment.

In the recent few years,apart from the development of interventional technology,the development of new kinds material for packing intracranial aneurysms has hastened the promotion of endovascular interventional treatment greatly. Microvention company introduces lately Hydrocoil,a kind of hydro-agglutinated microspring coil which adopts a special hydrolink detachment technology,enriching the methods of endovascular treatment for cerebral aneurysms. Hydrocoil is a traditional platinum coil coated with expandable,unabsorble hydrogel material,which can improve the filling volume proportion of the aneurysm. At present it has been initially applied in clinic. This article summarizes the characteristics,the preclinical study,and the clinical application of Hydrocoil.(J Intervent Radiol,2007,16: 710-713)