China ; Facial Injuries ; surgery ; Humans ; Mouth ; injuries ; Traumatology

Primary hypophysitis includes 3 subtypes:lymphocytic,granulomatous and xanthomatous hypophysitis. The primary hypophysitis has a low morbidity and the final diagnosis is mostly determined based on the pathological findings after operation.Now it is considered as an organ specific autoimmune disease.Its clinical manifestations and imaging features are similar to hypophyseal tumor,but the endocrine and pathologic features are different.Glucocortieoid pulse therapy and surgery are the two methods of treatment.

Objective To evaluate the long-term effect and safety of triple antiplatelet therapy(cilostazol,aspirin and clopidogrel)for the patients with diabetes and acute coronary syndromes(ACS)undergoing percutaneous coronary intervention(PCI).Methods Between December 2004 and February 2006,a randomized,single center trial was conducted in General Hospital of Shenyang Command for comparison of dual and triple antiplatelet therapy after PCI for the patients with ACS.Of 263 diabetic patients enrolled in present study,122 were randomly assigned to standard dual antiplatelet treatment with aspirin and clopidogrel,141 were assigned to triple antiplatelet therapy with aspirin,clopidogrel and cilostazol.Primary endpoint was a composite of cardiac death,non-fatal myocardial infarction(MI),stroke or target vessel revascularization(TVR)at 1 year.Results Baseline clinical and angiographic characteristics were comparable between the two groups.No definite stent thrombosis or MI occurred in either group during the period of follow-up,and no significant difference existed yet in the rates of 1-year cardiac death(4.1% vs 1.5%,P=0.255),stroke(3.3% vs 0.7%,P=0.186)and TVR(12.3% vs 7.8%,P=0.223)between the patients received dual or triple antiplatelet therapy.The rate of primary events was 9.9%(14/141)in triple group,which was significantly lower than that in dual group [18.9%(23/122),P=0.038].Patients receiving hypoglycemic medicine got more benefits from triple antiplatelet treatment.There was no significant difference between the two antiplatelet regimens regarding the risk of hemorrhagic events and premature discontinuation of aspirin or clopidogrel.Conclusion The regimen of cilostazol plus aspirin and clopidogrel for diabetic patients undergoing PCI is effective and safe in reducing long-term adverse cardiac and cerebral-vascular events,especially for the patients with high dangerous DM complicated with ACS.

Objective To compare F-Z solution with UW solution in preserving efficacy at cell level. Methods The LDH content in supernatant of endothelial cells after preservation-rewarming to determine the injury after preservation-rewarming. MTT was used to determine the activity of endo-thelial cells after preservation-rewarming. Results After being preserved for 24 h, the LDH content in supernatant of endothelial cells in UW group was not significantly different from that in F-Z group.After preservation for 48 h, there was no marked difference in the activity of endothelial cells between the 2 groups. Conclusion F-Z solution and UW solution have the same effect in reducing injury and maintaining activity of endothelial cells after preservation-rewarming at cell level.

Objective:To study changes of serum concentrations of high mobility group protein B1 (HMGB1),endo- thelin (ET )-1 and macrophage migration inhibitory factor (MIF ) in patients with type 2 diabetes mellitus (T2DM)complicated coronary heart disease (CHD)and explore their correlations with inflammatory factors.Meth-ods:The 120 patients with T2DM+ CHD treated in our hospital from May 2013 to Sep 2014 were enrolled in obser-vation group,including 30 cases with SAP,30 cases with UAP,30 cases with NSTEMI and 30 cases with STEMI. Another 30 T2DM cases without cardiovascular diseases during the same period were enrolled as pure DM group.En- zyme linked immunosorbent assay was used to measure concentrations of HMGB1,ET-1,MIF,CRP,TNF-α,IL-6, IL-8,IL-17 and IL-23,and they were compared among above groups.Results:Compared with pure DM group, there were significant rise in serum concentrations of HMGB1 [(3.49±0.52)μg/L vs.(9.18±1.02)μg/L],ET- 1 [(104.54±12.56)ng/L vs.(256.56±34.16)ng/L],MIF [(87.78±10.52)ng/L vs.(178.32±21.34)ng/L], CRP [(6.28±0.84)mg/L vs.(16.52±2.15)mg/L],TNF-α[(8.54±1.09)ng/L vs.(21.91±2.76)ng/L],IL- 6 [(2.25±0.34)ng/L vs.(6.34±0.82)ng/L],IL-8 [(7.23±0.94)ng/L vs.(15.41±1.97)ng/L],IL-17 [(65.34±8.32)ng/L vs.(141.62±20.18)ng/L]and IL-23 [(125.22±14.23)ng/L vs.(321.12±41.54)ng/L] in observation group,P<0.05 or <0.01. The serum concentrations of HMGB1,ET-1 and MIF were SAP group

Objective To determine whether urinary neutrophil gelatinase-associated lipecalin (uNGAL) and urinary intedeukin-18 (uIL-18) are early markers of acute kidney injury (AKI) in critically ill patients. Methods Ninety-two critically ill patients were studied for one week after their enrollment into our hospital. During the study, 46 patients who met the RIFLE criteria were selected as AKI group and the remaining 46 patients without AKI taken as a control group. The two groups were matched for age, gender and illness severity. Urine samples were collected daily for one week. The receiver operating characteristic curve was used to evaluate the early diagnostic value of uNGAL, uIL-18 and serum creatininc (SCr). Results As compared with the levels obtained 3 days before the diagnosis of AKI, the uNGAL levels in the AKI group increased significantly (P <0. 05), while uIL-18 and SCr levels did not change 2 days prior to the diagnosis of A KI (all P > 0. 05). uNGAL and uIL-18 levels increased significantly (all P < 0. 05), while SCr levels did not change 1 day prior to the diagnosis of AKI in the AKI group (P > 0. 05). The levels of uNGAL, uIL-18 and SCr did not change significantly in the control group during the study period (all P > 0. 05). Three days before the diagnosis of AKI, concentrations of uNGAL, uIL-18 and SCr were not the predictive of AKI. Two days before the diagnosis of AKI, the area under the curve (AUC) of uNGAL was 0. 840 (95% CI 0. 672-1. 009, P < 0. 05), which indicated that uNGAL was the predictive of AKI while uIL-18 and SCr were not. One day before the diagnosis of AKI, the AUC of uNGAL and ulL-18 were 0. 830 (95 % CI 0. 711-0. 950, P < 0. 05) and 0. 818 (95 % CI 0. 697-0. 938, P < 0. 05), indicating that uNGAL and uIL-18 were the predictive of AKI while SCr was not. Conclusion uNGAL and uIL-18 may be the early predictive markers of AKI in critically ill patients.

Objective To evaluate the value of tomographic ultrasound imaging(TUI)in the fetal heart screening.Methods One hundred and ten volume datasets acquired from normal fetal heart in the second trimester with spatio-temporal image correlation(STIC) were evaluated offline with TUI. The Bmode and CDFI static images as well as the dynamic loops of one cardiac eycle could be reviewed simultaneously. The visualizing rate and ultrasonic scores of the 4 chamber view,outflow tracts and 3 vessels (and trachea)view obtained from TUI and routine ultrasonography for fetal heart screening were respectively compared. Results Among all 110 cases,the visualizing rate of 4 chamber view,outflow tracts and 3 vessels(and trachea) view were respectively 100%(67),88.9%(45),80.0%(45),84.4%(32)in Bmode and 100%(33),86.2%(25),50.0%(14),100%(4)in CDFI under the same fetal Dositi.n.No significant differences of the visualization rate were found between TUI and routine screening either in Bmode or in CDFI(P＞0.05). The median score of 4 chamber view of TUI in B-mode was little higher than that in routine screening,while the right outflow tract of screening in CDFI significantly higher than that of TUI(P＜0.05). Conclusions The visualizing rates and qualities of TUI are sufficient for fetal heart screening offline as well as routine ultrasonography online in second trimester.

AIM: To study the effect of sphingosine 1-phosphate (S1P) on the increase in microvessel permeability induced by platelet activating factor (PAF). METHODS: The microvessel permeability was assessed by measuring hydraulic conductivity (Lp). To observe the effect of S1P and PAF on vascular endothelial-cadherin (VE-Cadherin), the microvessels were stained with immunofluorescence and examined by laser confocal microscopy. RESULTS: After giving PAF at concentration of 10 nmol/L, the Lp value of rat mesentery microvessel was significantly increased. However, after pretreatment with S1P, PAF did not give rise to a further significant change. The effect of PAF on microvascular endothelial cells could be seen: the formation of endothelial gap was induced, the microvascular fluorescence intensity significantly increased, a large number of fluorescent microspheres (FMs) distributed in the space among the endothelial cells. However, after pretreated with S1P, no obvious gap opening and the FMs accumulation were observed. Compared to normal control, no significant difference of the microvascular fluorescence intensity was found. CONCLUSION: PAF changes the structure of VE-Cadherin, leading to detachment of adherent junction, formation of intercellular gaps, which contributes to the increase in the permeability. S1P improves the increase in the microvessel permeability caused by PAF, which might be mediated by strengthening adherent junction and inhibiting the formation of endothelial gaps.

Objective To observe the major adverse reaction of irinotecan in combination with fluorouracil for advanced colorectal cancer,and sum up the nursing experience of acetylcholine syndrome and acute delayed diarrhea.Methods Pathologically confirmed 45 cases of patients with advanced colorectal cancer were treated with modified FOLFIRI regimen for total of 190 cycles.Results Acetylcholine syndrome rate was 28.9%,the incidence of acute delayed diarrhea was 40.0% ,more than 3 grade diarrhea was 6.7%.Conclusion The incidence of acute delayed diarrhea in Chinese patients is lower than in caucasians,and reasonable care measures can reduce the occurrence of adverse reactions,irinotecan in combination with fluorouracil is a safe and effective regimen for Chinese patients.

Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.