Objectives Pancreatic ischemia is a pathogeny of acute pancreatitis(AP), and systemic blood rheologic changes have close relationship with AP. The aim of this study was to investigate the potential role of the systemic blood rheologic and pancreatic hemodynamic changes in rats with AP, and to reveal their relationship. Methods Acute edematous pancreatitis(AEP, n =20) and acute necrotizing pancreatits(ANP, n =20) models were induced by injection of sodium taurocholate into the pancreatic duct of rats, another 10 normal rats were used as control group. The pancreatic blood flow(PBF) was measured by Doppler ultrasound before and after the operation. At 12 h after the induction of AP, 10 rats in each group were sacrificed, the blood rheologic indexes were detected, and the pathological study of pancreas was performed. The survival rate in 3 days of the rest 10 rats in AEP and ANP group was also observed. Results Compared with the control group, only the hemagglatination index increased in AEP group and all the blood rheologic indexes increased in ANP group distinctly with the elevation of blood viscosity curve. The velocity of PBF was decreased in AEP and ANP groups, reducing to 79% and 30% of theirs levels before the induction of AP. Compared with the control group, the pathological scores of pancreatic edema, inflammation, hemorrhage and necrosis of AEP rats significantly increased, and compared with AEP group, these four indexes increased significantly in ANP rats. The survival rate in 3 days of AEP group was 90%, but that of ANP group was 0. Conclusions Systemic blood rheologic and pancreatic hemodynamic changes happen synchronously in rats with AP. The injury of pancreatic microcirculation due to ischemia is one of the initial pathogeneses of AP. The change of blood rheology is not a contributing factor causing AP, it could aggravate pancreatic ischemia and accelerate the pancreatic injury after onset.

Objective To explore protective effect of Anisodamine against injure of cochlea hair cells induced by ionizing radiation. Methods 50 healthy guinea pigs were randomly divided into 3groups: radiation group( n = 20) , anisodamine protective group( n = 20) and control group( n = 10). 20ears were observed in each group. Tempora of guinea pigs in anisodamine protective group and radiation group were exposed to fractional doses of 6 MeV electron beam produced by linear accelerators (2 Gy/d)with a total dose of 60 Gy. Animals were injected intramuscularly with anisodamine (20 mg/kg) in protection group and equal saline solution in irradiated group, respectively, 30 min pre-irradiation.Morphological and functional changes in the guinea pig cochlea were observed. Results After radiation,the average ABR threshold value of the radiation group (52. 27 ± 2.42 dB peSPL) was significantly higher than that of the anisodamine protection group (37.65 ± 1.92 dB peSPL, t = 2.01, P＜ 0.05 ), and outer fair cells of cochlea reduced greatly in quantity by observing the stretched preparations of cochlea basilar membrane ( F=135. 362, P＜ 0.05 ). Under transmission electron microscope, outer fair cells of cochlea in the radiation group had obscure boundaries and swelled to lose their original shapes. Meanwhile, cell implement and the nucleus were obviously obnormal after radiation. In the anisodamine protection group,the boundaries of cochlea outer fair cells were very clear and the cells swelled a little. Cell implement and nuclear envelope were complete. Cochlea outer fair cells in the control group were found to line up in order with no collapse and reduction in number under scanning electron microscope, but those in the radiation group collapsed obviously, reduced in number and aligned in a state of chaos, while the outer fair cells in the anisodamine protection group regularly posed on the whole and the collapse was occasionally found.Conclusions The 60 Gy radiation at fractioned dose on the tempuses of the guinea pigs could cause damage to the cochlea hair cells. Anisodamine might have a protective effect against radiation damage.

Objective To investigate the relationship between blood concentration of sodium valproate and the anti‐epileptic effect and the influencing factors of blood concentration of sodium valproate ,and to provide evidence for clinical individual adminis‐tration .Methods The blood concentrations of 133 cases of patients treated with sodium valproate were determined in the affiliated Yongchuan hospital of Chongqing medical university ,the monitoring results of blood concentration were statistically analyzed ,and the anti‐epileptic effect of 133 cases of patients were observed and analyzed .Results The epilepsy of 80 cases of patients were con‐trolled ,accounted for 60 .15% of the total number;in the 69 cases of patients within the effective blood drug concentration (50-100 mg/L) ,the epilepsy of 51 cases of patients were controlled ,accounting for 38 .35% .In the 44 cases of patients whose blood drug concentration were less than 50mg/L ,the epilepsy of 26 cases of patients were not controlled .The distribution of blood concentra‐tion between men and women were similar .The blood concentrations among each age group were different ,the blood concentrations of 52 .87% patients in the adult group were below or above therapeutic range that were 39 .13% in the minor group .The adverse reactions were increase with the increase of blood concentration .Conclusion There are differences between the blood concentrations of sodium valproate and clinical effect ,the reasonable individual administration should be conducted according to the patient′s blood concentrations of sodium valproate ,the epilepsy control situation of patients and the patients′age .

OBJECTIVE: To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion. METHOD: Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy. RESULT Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.
Adenocarcinoma ; Humans ; Laryngectomy ; Larynx ; pathology ; Larynx, Artificial ; Neoplasm Invasiveness ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; Trachea ; pathology

OBJECTIVE: To evaluate the relation between the incidence of sinusitis and the position of the inferior border of the middle concha related to the semilunar hiatus. METHOD: Clinical data of 94 cases (185 sides of paranasal sinus) diagnosed by CT detection, operative findings and clinical features were analyzed. The middle concha was divided into 3 types according the position of its inferior border related to the semilunar hiatus: superior hiatus type (the inferior border of the middle concha superior to the semilunar hiatus), hiatus type (the inferior edge of the middle concha at the level of the semilunar hiatus) and inferior hiatus type (the inferior edge of the middle concha inferior to the semilunar hiatus). Statistic analysis were taken for comparing the incidence of sinusitis among the position of the middle concha and other anatomical variations such as deviation of nasal septum, pneumatization of middle concha, paradoxical curve of the middle concha, variations of the uncinate process, ethmoidal bulla enlargements, Haller cells and agger cell pneumatization. RESULT: There was no significant difference of the anatomic variations by comparing the superior hiatus type together with the hiatus type versus the inferior hiatus type (P > 0.05). But the incidence of sinusitis in each type was remarkably different, the superior hiatus type and hiatus type had more sinusitis than the inferior hiatus type. Furthermore, the second and third type of sinusitis in the superior hiatus type and hiatus type weighted over the inferior hiatus type (P < 0.01), while the first type didn't (P > 0.05). CONCLUSION There is no association between the position of the middle concha and the anatomic variations of the nasal cavity and paranasal sinus. The poorly developed middle concha may acts as a risk factor for sinusitis and nasal polyps.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; diagnostic imaging ; Sinusitis ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo summarize and analyze the clinical features, diagnosis methods, surgical approaches and treatment outcomes of patients with primary parapharyngeal space tumors.

METHODSA retrospective review of 91 cases with primary parapharyngeal space tumors treated from January 1999 to December 2011 was performed. All patients underwent preoperative enhanced CT scan and postoperative histopathologic examination. Intraoperative frozen section biopsies were performed in 36 of 91 cases. The surgical approaches included trans-cervical approach in 73 cases, trans-parotid approach in 5 cases, trans-oral approach in 5 cases, and mandibulotomy in 8 cases.

RESULTSThe postoperative pathological diagnoses consisted of 29 variants, including 20 for benign tumors and 9 for malignant tumors. Of the 80 cases with benign tumors, 6 cases were lost to follow-up and 74 cases were followed up for 31-84 months with no recurrence. Eleven cases with malignant tumor were followed up for 8-51 months (median 29 months), of them 7 cases died and 1 case was lost to follow-up. The post-operative complications included Horner syndrome in 3 cases, hoarseness in 2 cases, hypoglossal nerve palsy in 1 case, accessory nerve palsy in 1 case, upper airway obstruction in 1 case, and internal carotid artery cavernous sinus fistula in 1 case.

CONCLUSIONSParapharyngeal space tumors are rare, with atypical clinical manifestation, and have pathological types of diversification. CT or MRI is helpful to evaluate the tumor size, location and possible sources, and to make operation scheme. Surgery is the first choice for parapharyngeal space tumors. Trans-cervical approach can be applied to most tumors. Parapharyngeal benign tumors have good prognosis, but malignant tumors have poor prognosis.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Head and Neck Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult