Synovial sarcoma is a malignant soft tissue with unknown origin. Although head and neck region is the second common site of involvement, rare cases have been reported in Para nasal sinus and larynx. We presented two cases of synovial sarcoma, one of which arised from maxillary sinus and the other from laryx, and re- view the literature to sum up the diagnosis and treatment strategies. The conclusion is that synovial sarcoma in the head and neck still raises diagnostic and therapeutic issues. Surgical excision with wide margins is essential and necessary, usually associated radiotherapy. The effect of chemotherapy remains to explored.
Head and Neck Neoplasms ; pathology ; Humans ; Larynx ; Maxillary Sinus ; Paranasal Sinuses ; Sarcoma, Synovial ; pathology

Objectives To investigate antimicrobial resistance and beta-lactamase production of Moraxella catarrhalis isolates from respiratory tract in children and to understand the characteristics of BRO beta-lactamase gene. Methods From June 2011 to Sep-tember 2012, 401 Moraxella catarrhalis isolates were obtained from respiratory tract in children. Minimum inhibitory concentrations (MIC) of commonly-used antibiotics were determined by microbroth dilution assay, and beta-lactamase production was detected by Nitroceifn disk test. PCR combining restriction endonuclease analysis was employed to do the BRO genotyping. Results 96.5%iso-lates were beta-lactamase positive (387/401), MIC (MIC50/MIC90) values and resistant rates of beta-lactamase producing isolates were higher than those of non beta-lactamase producing isolates for ampicillin, cefaclor and cefuroxime (P<0.05). The positive rate of BRO gene was 99.2%in beta-lactamase producing isolates (384/387), consisting of 93.0%BRO-1 isolates and 7.0%BRO-2 isolates. MIC50 and MIC90 values of BRO-1+isolates were higher than those of BRO-2+isolates for ampicillin, cefaclor, cefuroxime and azithromycin. Conclusions The beta-lactamase production rate is high in Moraxella catarrhalis isolates from respiratory tract in children. BRO-1 type was the dominant genotype of beta-lactamase producing isolates, having more inlfuence than BRO-2 type in the inlfuence on some beta-lactams and macrolides.

On the model of isoprenaline (ISO)-perinjured rat heart, the protctive effect of ischemic preconditioning (IPC) on ischemia reperfusion (I/R) damage was observed.It was found that compared with alone I/R group,IPC ameliorated I/R-induced reduced reduction of coronary blood flow (CBF) (8. 8 + 0. 6 vs 6. 6 + 0. 4mL/min,P

Objective To analyse the levels of estrogen in women patients with Alzheimer's disease(AD),and the relationship of estrogen level,menarche age,age of menopause,pregnancy times with severity of AD.Methods A 1:1 matched case-control study was conducted.The study subjects were given neuropsychological test face to face in questionnaire,including MMSE,ADL,POD,FOM,WISE and HMT depression scale.All the women subjects accepted another questionnaire concerning menarche age,age of menopause and pregnancy times.Radioimmunoassay was used to measure the sex hormone level of all the subjects.Results The level of estrogen in serum was obviously lower in AD group than in the control group(P

0.05). Estrogen was lower in the patients with AD than in the normal controls and there was a significant difference between the two groups (P

Objective Through the analysis of the special thromboelastography (TEG) graphics to improve the ability of analysis and identification the TEG and provide more valuable results for clinical practice.Methods This study is a retrospective study.Retrospectively analysis of 15 430 cases of TEG results from People's Liberation Army General Hospital,using the parametrs as reaction time (R),the clotting time (K),the solidification angle (Angle),the maximum amplitude (MA),the percentage of blood clot dissolution (EPL),the rate of 30 minutes clot amplitudereduce (LY30),the coagulation index (CI) and other parameters to analyze the hyperfibrinolysis group,the heparin graphics group,the secondary activation of fibrin group,the platelet function group and the anti-platelet drug monitoring group.Results In the hyperfibrinolysis group,the EPL value,LY30 value and CI value of primary hyperfibrinolysis group was 19.3,19.3 and 0.4 respectively and the secondary hyperthyroidism group was 11.6,11.6 and 3.2 respectively.In the heprin application graphic group,R value of CKH group was shorter than that of CK group (10.9 vs.50.8),R value of CKH group was longer than that of CK group (12.2 vs.15.7).In fiber protein secondary activation graphics groups,the MA value of the first time detection was 35.2,then replacing the channel repetition MA value was 34.7 in true functional fiber protein secondary activation group.For the pseudo fiber protein secondary activation group the first time detection MA value was 73.4,then replacing the channel repetition MA value was 20.0.The MA value of platelet function reduce group and hyperfunction group was 21.6 and 79.2 respectively in platelet function group.In anti-platelet drug monitoring group,the inhibition rate of adenosine diphosphate (ADP) of ADP inhibitor (clopidogrel) ineffective group was 10.9％ ; And the inhibition rate of arachidonic acid (AA)of AA metabolic pathway inhibitor (aspirin) ineffective group was 7.5％.Conclusions The correct judgment on the abnormal thromboelastography graphics is helpful to ensure the accuracy of the results andto reduce the occurrence of adverse events.

Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.

Objective To compare the screening effects between Wells and revised Geneva scores on suspected acute pulmonary thromboembolism (APTE),and to explore a optimum screening method for APTE in the emergency department of China.Methods The study was carried out by using random,crossed,prospective methods to compare the screening effects between Wells and revised Geneva scores for 167 suspected APTE patients in the emergency department of the First Affiliated Hospital of Xiamen University.Results The areas under the receiver operating characteristic curve of Wells and revised Geneva scores for screening APTE in the emergency department were (0.917 ± 0.022 ) and (0.927 ± 0.020),respectively ( P ＜ 0.05 ).The diagnostic concordance between the two score systems for predicting APTE was poor (Kappa value =0.276 ). In addition, the difference between their hierarchical discrimination for the possibility of APTE was statistically significant ( P ＜ 0.05 ).Compared with revised Geneva score,fewer patients were diagnosed with low clinical probability of APTE and more patients were diagnosed with intermediate or high clinical probability of APTE through Wells score.The patients with low chnical probability of APTE were excluded from pulmonary embolism in Wells or revised Geneva score.At intermediate clinical probability,the accuracy rate of Wells score for predicting APTE (9.64％) was lower than that (32.84％ ) of revised Geneva ( P ＜ 0.05 ).At high clinical probability,there was no significant difference between their accuracy rate [ (67.24％ vs.86.21％),P＞0.05]. Conclusions Revised Geneva score is more suitable than Wells score in screening suspected APTE patients in the emergency department in our country.

BACKGROUND: Oxfordshire Community Stroke Project(OCSP) is a new type of clinical classification for subdividing cerebral infarction(CI) conducted on the basis of a large-scale of investigation of stroke in the population of Oxfordshire Community, England in 1991. This kind of classification completely bases on the clinical manifestations without the help of diagnostic instruments, which can predict site and size of the lesion and the involved vessels.OBJECTIVE: To acknowledge the clinical classification of CI patients with Bamford's OCSP and its significance in predicting their long-term functional prognosis.DESIGN: Clinical observation, comparison and verified study based on patients.SETTING: Neurological department in a university hospital.PARTICIPANTS: Between January 1st and December 31st 2001, totally 126 patients with cerebrovascular disease were hospitalized in the Neurological Department of First Affiliated Hospital of Xi' an Jiaotong University,including 82 males and 44 females.METHODS: Totally 126 in-patients with CI were subdivided with Bamford's OCSP classification, and their disablity was assessed with Barthel index (BI)and modified Rankin Scale(mRS) when they were discharged and 3 months and 6 months later.MAIN OUTCOME MEASURES: Classification of patients with CI and their scores of BI and mRS when they were discharged and 3 months and 6months later.RESULTS: Of the 126 patients, 8(6. 3% ) patients were confirmed of total anterior circulation infarction (TACI), 29 (23. 0% ) of part anterior circulation infarction(PACI), 78(61.9% ) of lacunar infarction(LACI), 11(8.7%) of posterior circulation infarction(POCI) . They were followed-up for 6 months, and meanwhile 12 patients died. Of the other 114 cases the prognosis of TACI was the worst, while the prognosis of POCI and LACI was relatively better than that of PACI.CONCLUSION: CI is predominated by LACI. OCSP is effective for predicting long-term functional prognosis of patients with CI. But it is necessary to make multi-center prospective study on a much larger scale of samples of disease.

OBJECTIVE: To evaluate the quality of reports published in recent 10 years in China about quantitative analysis of syndrome differentiation for diabetes mellitus (DM) in order to explore the methodological problems in these reports and find possible solutions. METHODS: The main medical literature databases in China were searched. Thirty-one articles were included and evaluated by the principles of clinical epidemiology. RESULTS: There were many mistakes and deficiencies in these articles, such as clinical trial designs, diagnosis criteria for DM, standards of syndrome differentiation of DM, case inclusive and exclusive criteria, sample size and estimation, data comparability and statistical methods. CONCLUSION: It is necessary and important to improve the quality of reports concerning quantitative analysis of syndrome differentiation of DM in light of the principles of clinical epidemiology.