Objective To determine the diagnostic value of endoscopic ultrasound-guided cholangiography(EUSGC)with fine needle puncture .Methods Twenty-six patients with obstructive jaundice failed i n previous endoscopic retrograde cholangiopancreatography(ERCP) and magnetic res onance cholangiopancrcatography(MRCP) or have metallic foreign materials in some where of body. By a linear scanning echoendoscopy in conjunction with a 22-gau ge aspiration needle, transduodenal selective cholangiography was attempted.Results Cholangiography was successfully performed in all patie nts (EUSGC success 100% vs. ERCP 0%). No complications occurred in the patients. In 19 patients, abnormalities were found from EUSGC. Choledocholithiasis have b een confirmed by sphincterotomy(n=5),common bile duct strictures were confirmed by surgical operation(n=11).Three other patients have delayed excretion of co ntract medium.Conclusion EUSGC allows a safe and accurate alternative method for obtaining cholangiography in those patients when ERCP or MRCP failed.

Through analyzing and considering on concrete conditions of the clinical engineering, which finds that the function allocation of department is not accurate and summarizes that should based on the technical support work and gain the development opportunity in the initial stage. According to the service theory of "all patients as the center" combines with economic and social benefits to analyze the specific circumstances of provincial and municipal hospitals, the functions location and development idea of clinical engineering department in all levels of hospital are researched respectively so that all work can be carried out smoothly and complete the important mission which hospital endow with the subject.

Objective:To study the clinical manifestations and treatment of the primary cervical tracheal malig-nant tumor of children. Method:Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscope and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. Result:Five cases were followed up for three to eight years, and no recurrence was found. Conclu-sion: There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable dignosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.

Objective To observe the effect of treating generalized anxiety disorder with clearing heart and relieving rstlessness acupuncture combined with western medicine. Methods 87 patients with generalized anxiety disorder were randomly recruited into a control group and a treatment group. Both groups received conventional western medical treatment. On this basis, the control group was given conventional acupuncture therapy, while the treatment was given clearing heart and relieving restlessness acupuncture. The efficacies were evaluated with Hamailton anxiety (HAMA)scale and clinical global impression scale (CGI). The adverse reaction was evaluated with treatment emergent symptoms scale (TESS). Results One week after treatment, the efficacies and adverse reaction in the treatment group markedly decreased comparing with those before the treatment(P<0.05). Two weeks after treatment, the efficacies and adverse reaction of both groups decreased comparing with those before the treatment(P<0.01). Besides, the decrease continues with time passing by. One week after treatment, the HAMA score in the control group markedly decreased comparing with that of the control group (P<0.05), and the CGI score in the treatment group had no significant difference comparing with that of the control group(P<0.05). Conclusion The treatment of clearing heart and relieving restlessness acupuncture on generalized anxiety disorder has rapid effect and good compliance.

Objective To study the clinicopathological significance of Skp2 and E2F1 in the rhinosinus squamous cell carcinoma and chronic sinusitis. Methods Immunohistochemical method was used to detect the expression of Skp2 and E2F1 in the routinely paraffin-embed-ded sections of specimens from patients with rhinosinus squamoas cell carcinoma (n=49), chronic sinusitis (n=28). Results The expres-sive positive rates and scores of Skp2 and E2F1 in rhinosinus sqnamous cell carcinoma were significantly higher than those in chronic sinusitis (P<0.01). The expression positive rates and scores were significantly decreased in middle-differentiated rhinosinus squamous cell carcino-ma. The maximal diameter of mass was less than 3cm, and no-metastasis of lymphnode or no-infiltration of regional rhinosinus can be found in T1N0M0. While in the low-differentiated rhinosinus squamous cell carcinoma, the maximal diameter of mass was larger than 3cm, and metasta-sis of lymphnode or infiltration of regional rhinosinus can be found(T3N1M0,T3N2M0) (P<0.01). The closely positive correlation was found between the expression of Skp2 and E2F1 in the rhinosinus squamoas cell carcinoma. Conclusions Skp2 and E2F1 might be important biologi-cal markers for carcinogenesis, progression, biological behaviors and prognosis of rhinosinus squamous cell carcinoma.

Objective To investigate the changes of refractive status in 5-12 years old high mypoic children,and determine their visual prognosis after 5 years.Methods A total of 52 high myopic patients treated in our hospital,aged 5 years to 12 years,were enrolled in the study.Every enrolled patient underwent complete ophthalmological examinations every 6 months to 1 year,including best corrected visual acuity (BCVA),cycloplegic refraction,fundus examination and axial length measurement.Resuits The mean myopia progression of the 52 patients was (-0.66 ± 0.43) D per year.32 patients(61.5％)showed binocular progression,4 patients(7.7％)showed monocular progression,and 16 patients (30.8％) showed binocular stability.The myopic progression rate of the patients whose initial refraction from-6.0 D to-9.0 D was 86.4％,from-9.0 D to-12.0 D was 68.8％,and ＞-12.0 D was 42.9％,respectively,there were obvious differences (P ＜ 0.05).The myopic progression rate of the patients who had family history of high myopia was 88.2％,and no family history was 60.0％,there was obvious difference (P ＜ 0.05).The myopic progression rates were not significant different between different age level and different sex (all P ＞ 0.05).41 patients (78.8％) of high myopes demonstrated a final BCVA ≥ 0.5 in both eyes,and 34 patients(65.4％) ≥0.8.The rates of patients whose fmal BCVA ≥0.5 in both eyes were 95.5％,75.0％ and 57.1％ for whose initial refraction were from-6.0 D to-9.0 D,from-9.0 D to-12.0 D and ＞-12.0 D,respectively,there was obvious difference (P ＜ 0.05).Conclusion The 5-12 years old high myopic children will progress in a relatively quick level every year.The initial refraction level and family history of high myopia are risk factors associated with myopia progression.Most of high myopic children will have a relatively good vision.

ObjectiveTo explore the mechanism of extracorporeal shock wave (ESW) in treating osteogenic disorders and the ideal energy level. MethodsAfter success in marrow aspiration from patients' iliac crest, hMSCs were isolated by Percoll density gradient centrifugation and cultured in Dulbecco's modified Eagle's medium in a 5% CO2 and 37 ℃ incubator. Optimal ESW dose was determined by MTT of kinase-marked cytobiology. After hMSCs were exposed to ESW, their morphocytologic change, rate of adherence and doubling time were observed with IPCM. Enzyme cytochemistry reaction for the activity of alkaline phosphatase was also examined. ResultsESW of 5 kV and 100 times could increase cells' viability and proliferation (P<0.01), but higher than 7 kV would inhibit them. Rate of adherence of hMSCs in exposure group of passage 5 reached to 61.54%, which was significantly different from control group(P<0.05). Compared with control group, the MSCs' doubling time was short for 1.72 d (P<0.05). The curve of normal alkaline phosphatase activity of hMSCs was like type S, but ESW shortened its latent period, and promoted its peak time, which was significantly different from control group.ConclusionESW of 5 kV and 100 times can optimally promote the proliferation and activity of osteogen of hMSCs in vitro.

OBJECTIVE: To study the clinical manifestations and treatment of the primary cervical tracheal malignant tumor of children. METHOD: Five cases diagnosed as primary tracheal malignant tumor with fibrolaryngoscopy, CT scan and pathology were retrospectively analyzed and reviewed. Extraction of malignant tumor was performed with tracheoscopy and nasal endoscope after emergent tracheotomy below the tumor in 4 cases, and tracheotomy after intubation in 1 case. After operation, 4 children received radiotherapy, and 1 case received laser therapy add radiotherapy. RESULT: Five cases were followed up for three to eight years, and no recurrence was found. CONCLUSION There was no specific manifestation in early tracheal malignant tumor, but it was critical and emergent during symptoms appear. Imaging examination was a very invaluable diagnosis method. Optimal and effective therapeutic protocol is tracheostomy under local anesthesia to keep upper airway patency followed by surgical extraction and radiotherapy. It was not appropriate to have tracheal wall resection for children.
Adolescent ; Child ; Endoscopy ; Female ; Humans ; Male ; Nose ; surgery ; Retrospective Studies ; Trachea ; surgery ; Tracheal Neoplasms ; diagnosis ; surgery ; Tracheotomy ; methods

OBJECTIVE: To summarize the clinical features and the experiences of diagnosis and treatment of extramedullary plasmacytomas (EMPs), and to enhance the cure rates of EMPs. METHOD: Clinical data of 8 patients with EMPs in head and neck, who treated in our hospital from Jan. 1990 to Dec. 2004, were reviewed. Of 8 cases, 3 cases with the tumors occurred in nasal cavities, 1 in maxillary sinus, 2 in nasopharynx, 1 in posterior wall of oropharynx. RESULT: Eight patients who were all pathologic confirmed EMP accepted surgical resections of the tumors, and 4 of 8 cases were boosted radiation therapy post-operation. Four cases were still alive disease-free for more than 1, 5, 10 and 12 years after treatments, respectively. One died of local recurrence in 2 years, 1 died of multiple myeloma in 3 year, and 1 died of heart attack in 2 years after treatments, respectively. One lost follow-up. CONCLUSION EMPs in head and neck are low potential malignancy tumors. The diagnosis of EMPs mainly depends on clinical manifestations and pathological results. Surgery and radiation therapy are the main treatments for EMPs in head and neck.
Adult ; Aged ; Female ; Head and Neck Neoplasms ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Plasmacytoma ; diagnosis ; therapy ; Retrospective Studies

OBJECTIVE: To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes. METHOD: Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years. RESULT: The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up. CONCLUSION The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.
Adult ; Endoscopy ; adverse effects ; Eyelid Diseases ; diagnosis ; etiology ; therapy ; Female ; Granuloma ; diagnosis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; therapy