Objective To evaluate the practical value tumor from nasopharynxl and the base of nasal cavity . Methods 12 patients , among these 5 cases suffered from the tumor of the base of nasal cavity and 7 from nasopharynx , were treated from January 2001 to January 2005 . After general anesthesia the tumors were incised by hard palate approach , and the preoperative selective intraarterial embolization were used in three nasopharyngeal tumors, and The controlled hypotension were used during surgery ifnecessary.Results Two malignant tumors were changed the type of surgery after the operation quick freeze pathologic examination. The mucosal flaps of other 10 cases survived and the function of phonation、swallowing、respiration and mastication were normal. The patients remained free of disease after follow-up period of over 1 year. Conclusions The endoscopic managent of resection tumor of nasopharynxl and the base of nasal cavity by hard palate approach have great advantage to traditional hard palate approach.

Objective To study the epidemiological characteristics of the acute toxicosis cases in a general hospital of a metropolis. Methods The prospective study was performed from Jan. 1st, 2005 to Dec. 31st, 2006 in acute toxicosis patients admitted during that period. The data analyzed included sex, age, occupation, onset time, poisoning cause, variety of poisons, way of poisoning, emergency diagnosis, emergency treatment, etc. Results There were 315 poisoning patients treated during the study period, accounting for 2.33‰ of the total patients visiting in the emergency department. Among these poisoning patients, the sex ratio (males vs females) was 1∶0.84. The age of most of the patients ranged from 20 to 29 (35.9%) years old. Alcohol was the major cause of poisoning (38.4%), followed in order by poisoning due to drugs (20.6%), food poisoning (18.1%), chemical poisoning (10.2%) and pesticide poisoning (5.7%). There was predominant time of the occurrence of poisoning in a year, but it was more frequent in January, February, June, July, November and December. 85.1% of patients were poisoned by oral route. The occupation of patients was mainly technical personnel (21.0%), followed in order by farmers and the laborers, self-employed businessmen, persons taking care of household chores and the unemployed, etc. 98.1% of patients survived in the hospital. Mortality rate was 1.9%. Conclusions Young persons and technical personnel constitute the high-risk group of patients with poisoning. The main poisons were alcohol, drugs, food and other chemical poisons. The main route of poison intake was the digestive tract. There is no obvious seasonal regularity.

Objective The function of regional myocardium of patients with myocardial infarction(MI) treated by intra-coronary stenting was determined with quantitative tissue velocity imaging(QTVI).Methods Twenty healthy controls and 24 patients with acute anterior myocardial infarction underwent QTVI with high-frame rates. The myocardial tissue velocity imaging in the apical 4-chamber view and apical 2-chamber view and apical longitude view were digitized and stored. Off-line ventricular walls regional velocity profiles along long axis were obtained, and systolic peak velocities (Vs) and early and late diastolic peak velocities (V E and V A) of 12 regional segments were measured.Results Under normal and ischemic conditions, 6 ventricular walls showed significant basal-apical myocardial velocity in the long-axis reduction in V S and V E and V A were significantly reduced in the abnormal segments in patients with MI. Conclusion QTVI can be used to analyze regional myocardial motion in the long-axis quantitatively and synchronously;intra-coronary stenting can obviously improve regional myocardial function of left ventricle,especially the diastolic function.

Objective To design a private cloud storage system to guarantee intranet and internet data security and realize data sharing between multi platforms.Methods The idea and solution for building the system were proposed by analyzing the difficulty during hospital informatization.The infrastructure based on the idle computing resources in the existing virtual pool and the application platform by private cloud storage software were involved in the development of the system,and related software and hardware were integrated after adjustment and customization,and then the system came into being with easy operation and high performance-cost ratio.Results The system developed realized freely data storage and sharing,and implemented file encryption to control the applied range.Conclusion The system has the functions of malicious code scanning,cooperative office system and data auto-backup,synchronization,transmission,sharing and etc,which executes intranet and intemet data sharing based on physical isolation.

It is increasingly important and imminent that bilingual teaching in emergency medicine is carried out and promoted in Chinese medical universities,with the internationalization of education.This teaching has been implemented in 8-year students of the Faculty of Medicine in our university this year.The desired results have been achieved.We conclude that some links,such as choice of teaching materials,teaching staff levels and raising students'enthusiasm,should be strengthened to improve the quality of teaching.

Objective We aimed to evaluate the role of CD4 + CD25 + T regulatory cells in predicting the prognoses of patients with sepsis.Methods Patients with sepsis in Shanghai Changzheng Hospital from December 2013 to April 2014 were identified and grouped into survival group (SG,n =19) and death group (DG,n =9) in accordance with their clinical outcomes.CD4 + CD25 +T regulatory cell ratio,C-replication protein,bilirubin,procalcitonin,and coagulation function were tested on the 1st day and 7th day,and APACHE Ⅱ and SOFA were analyzed to assess the predictability of this group of cells.Results Twentyeight patients were identified,with a mean age of (60.36 ± 15.30) years,a mean APACHE Ⅱ score of (16.68±7.00),and a mean SOFA score of (7.18 ±3.78).Twelve (42.9％) of the individuals were accompanied with severe multiple trauma,and 10 (35.7％) were in septic shock,and 9 (32.2％) died of severe sepsis.The first day CD4 + CD25 + T regulatory cell ratios on the first day were 2.10％ (0.80,3.10)％ (SG) vs.1.80％ (1.15,3.65)％ (DG) (Z=-0.148,P=0.883),andonday7 were 0.90％ (0.30,2.80)％ (SG) vs.5.70％ (2.60,8.30)％ (DG) (Z=-2.905,P=0.004) presented significant predictability.Conclusions Dynamic monitoring of CD4 + CD25 + T regulatory cells could predict the prognoses of patients with sepsis and should be generalized in clinical emergency practice.

OBJECTIVEPeriodontal tissue remodeling includes remodeling of alveolar bone, periodontal ligament, and cementum. Cementoblast plays a main role in repairing root resorption. Canonical Wnt/β-catenin signaling can promote the odontogenic differentiation in osteoblast. However, the mechanism on how the orthodontic force influences the function of cementoblast and the relationship between the canonical Wnt/β-catenin signaling and Runx2 of cementoblast are not yet known. The aim of this study is focus on this relationship.

METHODSOCCM30 cementoblasts were subjected to mechanical strain by four-point bending system with tension stress for 0, 3, 6, and 12 h. They were pretreated with different concentrations of Dikkopf-1 (DKK1) for 48 h. Western blot analysis was performed to detect the β-catenin levels in the nucleus. Runx2 mRNA was observed by real-time quantitative polymerase chain reaction (RT-PCR). OCCM30 cementoblasts were then pretreated with 150 ng · mL(-1) DKK1 for 48 h and subjected to mechanical strain by FX4000T system with tension stress for 12 h. Western blot analysis was conducted to detect the β-catenin levels in the nucleus, and Runx2 mRNA was observed by RT-PCR.

RESULTSOCCM30 cementoblasts had significantly higher Runx2 mRNA and β-catenin levels after being loaded with mechanical stress. The amount of Runx2 mRNA in OCCM30 cementoblasts was significantly decreased by DKK1. When OCCM30 cemento-blasts were pretreated with DKK1 without stress, their β-catenin level was significantly decreased by DKK1 and Wnt signaling was blocked. When they were not pretreated with stress, the β-catenin level with DKK1 was lower than that without DKK1. Without DKK1, the β-catenin level in OCCM30 cemento- blasts increased afterbeing loaded with mechanical stress. With DKK1, the β-catenin level in OCCM30 cementoblasts, which were loaded with mechanical stress, was higher than that without mechanical stress.

CONCLUSIONCementoblasts had higher Runx2 mRNA expression under mechanical stress because of the Wnt/β-catenin signaling pathway effect.

Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3％,consistent with IIF method,and the total accordance rate of the both methods was 98.2％.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3％,24.8％,38.9％ of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0％,39.3％,63.6％ respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1％,25.0％,56.8％ respectively for C1,C2,C3) (P ＜ 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2％/26.8％ or 39.3％); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1％/19.5％ or 22.7％) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5％/21.4％ or 25.0％) and high risk of lung or upper respiratory tract infection (46.3％/28.6％ or 29.5％),but low incidence of neurologic symptoms (0％/ 3.6％ ％ or 11.4％).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.

Objective: To explore the diagnostic value of combined detection of blood osteopontin (OPN) and matrix metalloproteinase-9 (MMP-9) for in-stent restenosis (ISR) in patients after percutaneous coronary intervention (PCI). Methods: A total of 142 patients who received post-PCI coronary angiography (CAG) in our hospital were studied. The patients were divided into 2 groups based on if there were ISR condition: ISR group,n=21and Non-ISR group,n=121. The blood levels of OPN and MMP-9 were detected upon the follow-up CAG conduction and the basic clinical information with biochemical indexes were compared between 2 groups. Results: Blood levels of OPN and MMP-9 were signiifcantly higher in ISR group than those in Non-ISR group,P<0.001. Multivariate logistic regression analysis revealed that elevated levels of OPN and MMP-9 were the independent risk factors for post-PCI ISR occurrence (OR=2.861 and OR=3.343,P<0.01). The ROC area of OPN and MMP-9 for predicting post-PCI ISR occurrence were 0.821 and 0.887,P<0.001. Taking the optimal cut off value of OPN at 3.68 ng/ml and MMP-9 at 415.24 ng/ml, the combined detection could increase the sensitivity of detection (90.48%) and the negative predictive value (98.06%). Conclusion: Blood levels of OPN and MMP-9 are closely related to ISR occurrence in post-PCI patients, combined detection has certain predictive value for ISR occurrence, especially for negative predictive value.

Objective To investigate the effect of predeposit autotransfusion in operation of the patients with lumbar disc protrusion.Methods Fifty patients of transfusion with lumbar disc protrusion were assigned into two groups by stratified sampling randomly,30 patients whose blood were predeposited before operation in experimental group,and the other 20 patients whose blood were not predeposited before operation in control group.The blood loss,the blood requirements during operations,the hemotological routine indexes and the complications related to blood transfusion were compared respectively.Results The blood loss of experimental group [ (720 ± 665 ) ml ] perioperative period was lower than that of control group [ ( 1060 ± 558 ) ml ],but there was no significant difference between two groups (P ＞ 0.05 ).All the patients in experimental group went through perioperative period safely without allogenic blood transfusion.Hemoglobin,red blood cell and white blood cell were not significantly different between two groups before and after operation for 3,7 days (P＞ 0.05 ),the platelet count after operation for 7 days was significantly different between two groups (P ＜ 0.05).No complication was observed in experimental group but 1 case with complication was observed in control group.Conclusions Predeposit autotransfusion is an effective to avoid homologous blood transfusion and its complications for the patients with lumbar disc protrusion.Furthermore,the clinical effect is not significantly different between the predeposit autotransfusion patients and the allogenic blood transfusion patients.