OBJECTIVE: To review the pathological and clinical features and treatment of sinonasal malignant melanoma. METHOD: A retrospective analysis of 23 cases of sinonasal malignant melanoma. All the patients were conformed by histopathology, the most common symptoms were nasal obstruction and epistexis. Eight cases were treated with surgery, 8 with surgery and radiotherapy, 5 with surgery and chemotherapy, 2 with surgery and ra- diotherapy plus chemotherapy. RESULT: Twenty patients were followed up, the survival rates of 3 and 5 years were 50% (10/20) and 35% (7/20), respectively. CONCLUSION Sinonasal malignant melanoma has an aggressive behavior and easy recurrence and poor prognosis. Early diagnosis and reasonable treatment can increase the survival rate of the disease.
Humans ; Melanoma ; mortality ; pathology ; therapy ; Nasal Obstruction ; Neoplasm Recurrence, Local ; Nose Neoplasms ; mortality ; pathology ; therapy ; Paraganglioma ; Paranasal Sinus Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies ; Survival Rate

ObjectiveTo observe the morphology and structure of the urogenital hiatus in late pregnancy women using transperineal three-dimensional (3D) pelvic floor ultrasonography.Methods Twenty five nulliparas and fifty late pregnancy women were examined by transperineal 3D pelvic floor ultrasonography.The images of urogenital hiatus were obtained and compared to study their differences between nulliparas and late pregnancy women.Results Compared to nulliparas,urogenital hiatus in late pregnancy women tended to be circular and with an offset position.The puborectalis were bended and could be avulsed.Pelvic floor connective tissue could be loose.The morphology of vaginal might be abnormal and pelvic organ might prolapsed slightly.ConclusionsThe morphology and structure of urogenital hiatus in late pregnancy women are different to those in nulliparas,the hiatus tend to be slackness.3D pelvic floor ultrasonography is an effective imaging method to observe the morphology and structure of urogenital hiatus in pregnancy women.

Clerkship teaching of neurology is one of the important contents in clinical neurological teaching.Application of problem-based learning in combination with heuristic teaching can mobilize the initiative of students,enlighten their thoughts,arouse their flexibility and creativity and deepen the understanding of knowledge so as to achieve the purpose of improving clinical teaching effects.

Objective To evaluate the diagnostic value of translabial two-dimensional (2D) ultrasound for female anterior pelvic floor dysfunction,and to discuss the ultrasound appearance of anterior pelvic floor dysfunction.Methods Translabial 2D ultrasound was performed on 63 patients who were diagnosed or suspected with anterior pelvic floor dysfunction using pelvic organ prolapse quantitation system,the position and mobility of bladder neck,the retrovesical angle and urethral rotation were measured during maximum Valsalva maneuver.Different types of anterior pelvic floor dysfunction diseases were diagnosed according to the ultrasound findings.Results Translabial 2D ultrasound diagnose different types of anterior pelvic floor dysfunction diseases based on the position and mobility of bladder neck,retrovesical angle and urethral rotation,including 15 cases bladder neck hypermobility,9 cases funneling of the bladder neck and 37 cases cystocele.Conclusions Translabial 2D ultrasound could provide useful information of anterior pelvic floor and is of great value in the diagnosis of female anterior pelvic floor dysfunction.

Objective To dynamically observe and evaluate the position and movement of pelvic floor organs in vaginal delivery primipara with translabial two-dimensional(2D) ultrasound,and to provide the imaging basis for the effects of pregnancy and vaginal delivery on the pelvic floor support structures.Methods Translabial 2D ultrasound was performed on 52 vaginal delivery postpartum women (postpartum group) and 43 normal women as control group to observe the position and movement of pelvic floor organs at rest,on pelvic muscle contraction and during maximum Valsalva maneuver.Results The location of urethrovesical junction and cervix were significantly lower in postpartum group compared with the control group at three stages.The movement of urethrovesical junction and cervix in vertical direction was greater in postpartum group than control group during maximum Valsalva maneuver,while was smaller on pelvic floor contraction.Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of pelvic floor organs.Pregnancy and vaginal delivery produce certain effect on pelvic floor support structures,which manifest as weak,defective and dysfunction.The impact was more obvious in anterior and middle compartments.

【Objective】 To observe the effect of electroacupuncture(EA) onlearning and memoryin vascular dementia (VD) rats andto explore its possible therapeutic mechanism.【Methods】Fifty specific pathogenfree(SPF) adult rats were randomizedintofour groups.Except the 8 rats in the pseudo-operation group(group A),the other 42 rats were induced cerebral ischemia by four-vessel occlusion method.Then the model rats were randomized into model group (group B),EAgroup(group C) and nimotop group(group D).Groups Aand B were fed with the same forage and received no medication.Group Creceived EAonthe acupoints of Baihui,Geshu,Pishu and Shenshu,and EAwas set in continuous wave with the frequency being 150Hz,once per day and lasting 15 consecutive days.Group Dreceived nimotop 12mg/kg,qd,for 15 consecutive days.After 15-day treatment,the learning and memory abilities of the rats were observed by Morris water test,the plasma carbon monoxide(CO) level was detected by double-wavelength spectrophotometer,and brain nitric oxide(NO) content was examined byspectrophotometry-colorimetry.【Results】The model rats had obvious disorders of learningand memory,their escapelatency was prolonged,thetimes swimmingacross the platforminthe original quadrant did not differ fromthose inthe other three quadrants,and plasma COand cerebral NOlevels were obviouslyincreased.In EAgroup,escapelatency was shortened,thetimes swimmingacrossthe platform inthe original quadrant were more thanthose inthe other three quadrants,and plasma COand cerebral NOlevels were obviously decreased(P

Objective To investigate the safety and efficacy of autologous haematopoietic stem cell transplantation (HSCT) in treatment of patients with refractory inflammatory bowel disease (IBD). Methods Ten patients with active moderate-severe IBD [nine with Crohn's disease (CD) and one with ulcerative disease (UC)] were treated with HSCT from January 2004 to August 2006.Among 9 CD patients,the CD active inedx(CDAl) of 2 patients were above 450 (severe),6 patients were 150-450 (active).One patient was suffered from severe UC(whole colon).The stem cells were collected from the patients who intravenously received cycloptlosphamide (2.0 g/m2 ) and granulocyte colony-stimulating factor (5 μg · kg-1 · d-1 ).The CD34+ cells were isolated and cryo-preserved.After 2 weeks,the HSCT was carried out.Results In 9 patients with CD,clinical complete remission (CDAI<150) was achieved in 5 and 1 patients at 3 and 12 months after HSCT.The CDAI of other 2 patients decreased but not reached clinical complete remission.The patients were followed up of 16.1 months (ranged 10-33 months).The disease relapsed in 4 patients and complete remission in 5 patients.However,no improvement was observed under repeated eolonoscopy in 1 patient with UC who had not relapsed in 10 months.HSCT-related side effects included neutropenia caused fever,infection,etc.One HBV-carrier developed asymptomatie increase of liver enzymes and HBV-DNA copies after HSCT.Conclusions Autologous HSCT can be conducted safely and is well tolerated in patients with refractory IBD.It can induce clinical remission in most of the patients,although endoscopic remission may not be achieved,and relapses can not be avoided in some patients.

This article discussed on the continuing medical education for general practitioners within a nonprofit multihospital system.Literature review,statistical analysis and survey results were employed.Training situation for general practitioner at home and aboard was reviewed.Statistics on population,disease spectrum,present situation of community doctors in Luwan branch of Ruijin hospital was also analyzed.Results showed that current education system for general practitioners cannot catch up the increasing demand yet.Meanwhile patients expected well qualified and skillful physicians in the community healthcare centers.Reinforcement of continuing medical education for general practitioners was the stepping stone of a nonprofit multihospital system.Improving skills and qualifications of physician played an essential role in the urban network of medical services.

Objective To investigate correlative complication and disorders in growth of premature infants with congenital CMV infections before one year old.Methods Fifty-eight infected premature infants and sixty control premature infants were followed up prospectively for one year.The differences were compared between two groups with incidence of correlative complication.Physical growth,liver function,neurosonographic and audiologic examination were used to identify the sequelae of CMV infections.Results The numbers of infants with infantile hepatitis syndrome,encephalopathy of premature infant and SNHL were significantly higher in infected group than in control group(x2 =4.52,15.09,12.71,P ＜0.05).No difference between groups was found on physical growth.However,the significant difference between two groups was observed on abnormal for liver function of 3 and 6 months(x2 =8.33,17.28,P ＜ 0.05),neurosonographic after birth and 3 months(x2 =15.09,5.38,P ＜0.05),audiologic examination of 3 and 6 months(x2 =17.01,8.04,P ＜ 0.05).Conclusions These data suggest that congenital CMV infections may be associated with hepatitis syndrome,encephalopathy of premature infant and SNHL in premature infants.Liver function,neurosonograpphic imaging and ABRs were useful in the evaluation of the premature infants with congenital CMV infections.

Objective To evaluate the different effects of laryngeal mask and mask ventilation during bronchoscopy in elder patients. Methods 120 old patients (ASA I-III) were divided into three group according to the table of random number as following:surface anesthesia with autonomous respiration (group I);endoscope mask ventilation (group II);laryngeal mask airway ventilation (group III). Oxygen inhalation through nasal tube in groupⅠ,group II and group III was ventilated with endoscope mask and LMA respectively ,thenwe observed whether there were adverse effects or not during the procedure. Results The adverse reactions of group I were more than other groups. Compared with the group I, variance of MAP,HR, RR, SpO2 in the groupⅡand groupⅢ had less changes, the cases with severe bucking decreased significantly, and satisfaction degree increased markedly, (P <0.01or P<0.05 ) . The incidence rate of resp iratory depression and airway obstruction in groupⅡwas higher than that in groupⅢ (P<0.05). Conclusion Endoscope mask ventilation and LMA can both be adopted in analgesia bronchoscopy for old patient. LMA under general anesthesia to transbronchial lung biopsy would control respiration according to the demand at any time.LMA has more advantage in the operation for the stable respiration and hemodynamics and less complications.