A 47-year-old Chinese man with hypophosphatemic osteomalacia suffered from bone pain, difficulty in walking and pseudo-fractures. Biochemical examination showed a lowered serum phosphorus level and an elevated alkaline phosphatase level. The X-ray examination showed pseudo-fractures of multiple ribs, low bone density, biconcave deformities of the lumbar vertebrae, and pseudo-fracture of the right superior ramus of the pubis. A diagnosis of hypophosphatemic osteomalacia was made. The case was treated with oral neutral phosphate solution, calcitriol and Caltrate D. After treatment for two years, biochemical indicators were improved, and pseudo-fractures healed. Clinically, hypophosphatemic osteomalacia is often overlooked or misdiagnosed. In addition, the duration and dosage of these drugs should be appropriate, in order to avoid tertiary hyperparathyroidism or poor response to treatment.

Six cases of Paget′s disease of bone, including 5 males and 1 female, aged (57. 7 ±11. 8) years old, were recruited. Mean duration of disease was (7. 5±6. 5) years. Clinical manifestations were bone pain and bone deformity. The lesions mainly reside in the pelvis and femur. X-ray film showed typical lesion of Paget′s disease of bone, such as impaired bone trabecular structure with coarseness and disorder, cortical thickening, medullary cavity narrowing and skeletal deformation. Bone scan revealed abnormal radionuclide concentration in the involved bone. Serum alkaline phosphatase ( ALP) in 6 patients was increased ( median 235 U/ L). 5 patients received zoledronic acid sodium intravenous infusion therapy. Bone pain was relieved obviously in 5 patients after treatment for 2-3 months. Physical activity was greatly improved, and serum ALP levels significantly decreased.

Humans ; Neurosurgical Procedures ; methods ; Obesity ; Tracheostomy ; methods

The data of 6 patients with tertiary hyperparathyroidism were retrospectively analyzed.The first symptom in 3 patients was bone ache,1 with lower extremity weakness,1 with swelling of lower limbs,and 1 with increase serum alkaline phosphatase.5 patients had past history of renal failure,1 case suffered from severe intestinal malabsorption,and 4 of them had renal transplantation.X-ray showed subperiosteal bone resorption,bone demineralization,or cellulose osteitis.5 subjects presented with osteoporosis,and 1 of them had fractures.Left atrioventricular membrane calcification and gluteal calcification were found in each of 2 cases.4 patients suffered from hypercalcaemia,2 patients with normal serum calcium,4 with hypophosphataemia,and 6 with high levels of PTH.Pathological results showed adenoma in parathyroid gland in 4 patients and enlarged parathyroid glands in 2 patients.Serum calcium and PTH levels returned to normal after operation and calcium supplement.

Sixty-four patients with Graves' diseases were divided into methimazole group ( n =30 ) and propylthiouracil group( n =34 ).20 healthy volunteers were used as the control group.The levels of interleukin (IL) -2,IL-6,and TSH receptor antibody (TRAb) were determined by ELISA after serum samples were eollected before treatment and after treatment for 3 and 6 months.The results showed that the general data of two groups were not significantly different before treatment.IL-2 and IL-6 levels at 6 months after treatment were significantly different from the baseline (P＜ 0.05 ),IL-2 being gradually increased while IL-6 decreased with time.The level of IL-6 in methimazole group was lower than that in propylthiouracil group after treatment for 6 months ( P＜ 0.05 ).There was no significant difference in TRAb levels between two groups before treatment while differences became significant at 3 and 6 months of treatment ( all P＜ 0.01 ),being gradually decreased with time. IL-2/IL-6 ratio became significantly greater at 3 and 6 months of treatment compared with that before treatment in the same treatment group( P＜0.05 ) and the ratio in methimazole group was higher than that in propylthiouracil group by 6 months of treatment ( P＜0.05 ).IL-6level was positively correlated with FT3 and FT4 levels,and IL-2 level was negatively correlated with FT3,FT4,and TRAb levels in GD patients before treatment.The correlations of IL-2 and IL-6 with FT3 and FT4 disappeared by 3 and 6 months of treatment.IL-2 and IL-6 levels were related with TRAb level before and after treatment in methimazole group. These results suggest that the immunosuppressive effect of methimazole is more evident than that of propylthiouracil in patients with Graves' disease.

Objective:To compare the effects of different surgical treatment of chronic rhinitis-sinusitis difference,and its impact on transport function of maxillary sinus mucociliary,provide a clinical-surgical sinusitis preferably reference about the treatment of chronic nasal formulation for.Methods:From 2013.9-2014.12,otorhinolaryngology clinic in our hospital,160 cases were diagnosed as chronic nose-as research subjects were randomly divided into four groups of patients with sinusitis were treated from 1 to 4,60 cases in each group;treatment groupl receiving the maxillary sinus ostium augmentation,treatment group 2 received fenestration,treatment group 3 through tears crypt before maxillary sinus surgery,treatment 4 group receiving the maxillary sinus balloon dilatation;after covering the nasal mucosa observed and compared four groups of patients about edema,vesicle formation,bone exposure,scarring,etc.,as well as internal maxillary sinus secretions traits,volume situation,and compared patients after four groups line maxillary sinus cavity and perioral saccharin test biopsy cases three months and six months.Results:The four groups were made after surgery better clinical efficacy,and group efficacy 4 with the other three groups,the effect is most significant (all P ＜0.05),the difference was statistically significant,and after three months and six months,group 4 compared with other surgical group,the Lund-Kernedy score were also lower,MMT time were also lower,the difference was more significant (all P ＜0.05);in the maxillary sinus biopsy aspects:the number of postoperative inflammatory cells and dendritic cells and glandular cell morphology and submucosal edema improved submucosal structures also in the group of four most significant (P＜0.05).Conclusion:Maxillary sinus balloon dilatation treatment chronic nasal sinusitis curative effect is higher,which can effectively improve the cell and submucosal gland cell morphology and sinus mucosa edema,sinus unobstructed drainage effect,and high safety.

Objective To evaluate the clinical efficacy of coaxial micro-incision phacoemulsification for intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods A prospective randomized control study was conducted in 80 patients (80 eyes) taking tamsulosin more than two weeks with age-related cataract from October 2014 to October 2016.All cases were randomly divided into microincision group (MICS group) and standard incision group (SICS group),40 cases in each group.Coaxial 1.8 mm microincision cataract surgery was performed in the MICS group,and coaxial 2.6 mm standard incision cataract surgery was performed in the SICS group.The incidence and the degree of IFIS and complications were recorded during the operation.The uncorrected visual acuity (UCVA) was compared at 1 day,1 week,1 month after surgery.Results At postoperative 1 day,1 week and 1 month,UCVA was 0.83 ± 0.12,0.86 ±0.10,0.89 ±0.11 in the MICS group,and was 0.71-±0.12,0.75 ±0.11,0.83 ±0.12 in the SICS group,there were statistical differences (all P ＜ 0.05),the UCVA of MICS group was better than that of SICS group.The incidence of IFIS was 60.0％ in the MICS group,and 82.5％ in the SICS group,there was statistical difference (P ＜ 0.05).There was statistical difference on degree of IFIS between two groups (P ＜ 0.05),the degree of IFIS in the MICS group was lower than that in the SICS group.Conclusion The coaxial microincision phacoemuisification is a safe and effective surgery for the patients with cataract and high risk of IFIS.

Objective:To explore the predictive value of serum thyroglobulin autoantibody (TgAb) for recurrence / metastasisin of thyroglobulin (TG)-negative and TgAb-positive patients with differentiated thyroid carcinoma(DTC) after thyroid ablation.Methods:The clinical data of 57 patients with DTC,undergoing complete resection of thyroid tissue,TG negative and TgAb positive,who were reviewed in Liaocheng People's Hospital during April 2013 to April 2015,were selected and divided into recurrence/metastasis group (n=20) and no recurrence/metastasis group (n=37).The TG and TgAb levels in the two groups were detected and compared by the electrochemical luminescence method,the sensitivity,specificity,positive predictive value and negative predictive value of TgAb in the diagnosis of DTC recurrence / metastasis were analyzed;the independent risk factors of DTC recurrence / metastasis were analyzed by Logistic regression.Results:The TgAb levels(72～3850 IU/mL) in the recurrence/metastasis group was higher than that(18～3638 IU/mL) in the no recurrence/metastasis group,the difference was statistically significant (P＜0.05).The sensitivity,specificity,positive predictive value,negative preictive value of TgAb in the diagnosis of recurrence/metastasis of DTC were 85.71％,83.33％,75.00％,90.91％,respectively.Logistic Regression analysis showed that the 100≤ TgAb ＜204 IU/mL,204≤ TgAb≤ 1000IU/mL,and ＞ 1000IU/rnL levels of TgAb were the independent risk factors of rucurrence/metastasis ofDTC (OR=1.267,2.853,6.791,P＜0.05).Conclusion:TgAb can be used as evaluation of an important index of the recurrence/metastasis of patients with DTC when serum thyroglobulin (TG) was negative and TgAb was positive after thyroid ablation.The higher the TgAb levels,the more probability of the recurrence/metastasis.

Objective:To summarize the clinical characteristics of the patients suffering from sudden senserineural hearing loss (SSNHL) with benign paroxysmal positional vertigo (BPPV),and to investigate the possible pathogenesis.Methods:The clinical materials of thirsty-five patients with SSNHL complicated with vertigo were retrospectively analyzed.The clinical information,including the traits of vertigo and prognosis of hearing loss of the patients in SSNHL with BPPV group (n=9),and SSNHL with non-BPPV group (n=26) were compared.Results:All patients had profound hearing loss and unsatisfied prognosis of hearing loss,and the response rate was 17.1％,the effective rate was 11.4％,and the curative rate was 5.7％.25.7％ of all cases were diagnosed of BPPV by medical history and postural tests,who had heavier hearing loss than the others.And BPPV comlicated with SSNHL was often found within 1 week after the hearing loss (average value:4.1 d),and all on the same side with the hearing loss ear.BPPV tended to happen in total deafness (6 cases,66.7％) and flat type (3 cases,33.3％),and were often involved in horizontal semicircular canal (6 cases,66.7％) and posterior semicircular canal (3 cases,33.3％).The patients with SSNHL complicated with BPPV needed more times of reduction maneuver (average value:2.3 times),with a satisfied therapeutic effect for reducing the vertigo of the patients.Conclusion:SSNHL complicated with BPPV has a high morbidity in the patients with heavy hearing loss,and often affect the horizontal semicircular canal,which needs the repeated reduction maneuver.

Objective:To investigate the effect and mechanism of Grifola frondosa extract on inflammatory response of colon tissue in rats with ulcerative colitis(UC)by regulating interleukin-6(IL-6)/Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods:Forty SD rats were randomly divided into blank control group,UC model group,Grifola frondosa treatment group,western medicine treatment group and combined treatment group,with 8 rats in each group.After UC rats were established by free drinking 3%DSS for 7 days,the treatment group were given Grifola frondosa extract 10 mg/(kg·d),sulfasalazine 0.3 g/(kg·d),and the same amount of two drugs,for 14 consecutive days.During the experiment,general state of rats were observed,and the disease activity index(DAI)score was calculated;pathological changes of rats colon tissue were observed by HE staining;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in rats colon tissue were detected by Western blot;content of IL-6 in rats serum was detected by ELISA;protein contents and expressions of IL-6R and MPO in rats colon tissue were determined by immunohistochemistry.Results:Compared with blank control group,general state of rats in UC model group was poor,DAI score was increased,obvious tissue mucosal defects and inflammatory cell infiltration were observed by HE staining;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in rats colon tissue and contents of IL-6R and MPO were significantly increased(P<0.01);content of IL-6 in rats serum was significantly increased(P<0.01),the difference was statistically significant.Compared with UC model group,general condition of rats in each treatment group was improved,DAI score was decreased,HE staining showed that mucosal defects were improved to varying degrees,and occasionally inflammatory cell infiltration was observed;protein expression levels of IL-6,JAK2,STAT3 and p-STAT3 in colon tissue were significantly decreased(P<0.01),contents of IL-6R and MPO in colon tissue and content of IL-6 in serum were significantly decreased(P<0.01 or P<0.05),the differences were statistically significant.Conclusion:Grifola frondosa extract can reduce the inflammatory response in colon tissue of UC rats by regulating expressions of IL-6/JAK2/STAT3 signaling pathway related factors.