OBJECTIVE To explore the methods and effects of endoscopic nasal structure reshaping for treatment of chronic rhinosinusitis(CRS). METHODS One hundred and twenty-three cases of CRS patients with abnormal anatomy in nasal cavity and sinus were treated by the Messerklinger approach. At the same time varieties of anatomical abnormalities were corrected,including:①submucous resection of nasal septum,②submusous middle turbinate resection,③submusous inferior turbinate resection,④Uncinate process resection ⑤deal with frontal recess and its adjacent cells. RESULTS All patients were followedup for 1 to 2 years. One hundred and six cases were successful,14 satisfied and 3 inefficient. The rate of full recovery was 97.56%. CONCLUSION Reshaping nasal structure during endoscopic surgery is a method worth recommendation for structural rhinitis.

The paper analyzes the deficiencies of the traditional Hospital Information System (HIS),establishes the hospital data mining and analysis platform,introduces the platform architecture,builds the data mining models themed by analysis of hospital leaders,supervision and management of antibacterial drugs,analysis of hospital quality,analysis of single disease,expenditure control by medical insurance,etc.,and puts forward the smart solutions to improve the service tevel of hospitals on the basis of above.

Objective To discuss the preventive strategy of complications in reoperation of differentiated thyroid carcinoma (DTC).Method Clinical data of 114 patients with DTC who needed reoperation because of recurrence or inadequate operation were reviewed retrospectively.The reoperations included total thyroidectomy for 101 cases,lobectomy for 13 cases,central compartment neck dissection for 94 cases,and lateral neck dissec tion for 65 cases.Results 8 cases (8.77％) suffered from temporary RLN injury,one patient (0.88％) has permanent nerve palsy.Nerve dysfunction recovered after reoperation in 4 cases who had suffered from recurrent laryngeal nerve palsy in previous operations.Transient hypoparathyroidism occured in 10 patients (8.77％),and per manent hypoparathyroidism happened to 2 patients (1.75％).Conclusion For patients undergoing reoperation,detailed preoperative examination,proper operative approach,meticulous dissection on the thyroid capsule,visual identification of RLN followed anatomic landmark and intraoperative nerve monitoring (IONM) are key factors to reduce complications in reoperation of DTC.

Objective To investigate the correlation between level Ⅱ cervical lymph node metastasis (CLNM) and thyroid disease background,tumor size,location,and local lymph node metastasis in patients with papillary thyroid carcinoma (PTC).Methods A thyroid cancer database was established using Access database software.62 patients with PTC undergoing neck dissection in the 1st Department of Head and Neck surgery of Sichuan Cancer Hospital from Aug.2013 to Mar.2014 were retrospectively reviewed in terms of their sex,age,thyroid disease background,number of nodules,tumor size,location,and CLNM.Results 30 out of 62 patients had level Ⅱ cervical lymph node metastasis (Ⅱa:27 cases,Ⅱb:6 cases).13 out of 23 patients without history of other thyroid disease had level Ⅱ CLNM,9 out of 17 patients with Hashimoto's thyroiditis had level Ⅱ CLNM,3 out of 18 patients concomitant with nodular goiter had level Ⅱ CLNM and 2 patients concomitant with hyperthyroidism and having received radioactive iodine 131 treatments had level Ⅱ CLNM.Among patients with level Ⅱ CLNM,2 patients had tumors ＜10 mm,17 patients had tumors between 10 mm and 40 mm,and 4 patients had tumors ＞40 mm.Most of the tumors (11/17) with level Ⅱ CLNM were located in the upper polar of the thyroid,while the rest were located in the middle (12/23) and lower (3/12) region of thyroid.Conclusions Level Ⅱ CLNM is a common feature of thyroid carcinoma.It has been well accepted that level Ⅱ cervical lymph node should be dissected when extracapsular invasion or CLNM to level Ⅲ or Ⅳ occurs.In addition to traditional risk stratification,level Ⅰ CLNM is correlated with tumor size,location,and thyroid disease background.Therefore,close attention should be paid to level Ⅱ cervical lymph node when tumors are located in the upper polar of thyroid and individualized treatment should be chosen for each patient.

OBJECTIVE To investigate the efficacy and feasibility of endoscopic surgery to manage the tumors involving naso-ethmoidal complex and anterior skull base.METHODS 19 cases of tumors involving nasal cavity,ethmoid sinus and anterior skull base were summarized retrospectively, including 3 cases of ethmoidal squamous carcinoma, 3 cases of esthesioneuroblastoma,3 cases of melanoma,1 case of plasmocytoma,2 cases of ethmoidal adenocarcinoma,4 cases of adenoid cystic carcinoma,2 cases of meningioma.RESULTS Tumors were totally removed in 18 cases and subtotally removed in 1 case,all the cases were followed up for 1 to 3 years.Of the 3 cases of melanoma,1 case died of brain metastases 1 year after surgery,1 case recurred 8 months after surgery,1 case of adenoid cystic carcinoma recurred 17 months after surgery.No recurrence were found in the rest 16 cases during 1-3 years of following-up.CONCLUSION Endoscopic surgery is a effective method for malignant tumors localized in nasal cavity and ethmoid sinus and benign anterior skull base tumors involving nasal cavity and sinuses.Indication must be carefully selected for malignant tumors and postoperative radiotherapy should be advised.

Objective To analyze the pulse-field gel electrophoresis (PFGE) patterns and antibiotic resistance of Salmonella enteritidisstrains isolated in Longyan city in order to provide reference for effective control, clinical diagnosis and treatment of outbreaks of food-borne diseases.Methods Seventy-seven Salmonella enteritidis strains isolated from food poisoning cases, livestock and poultry meat samples collected for food safety risk monitoring and sporadic cases in 2014 and 2016 were analyzed by PFGE.Antibiotic susceptibility testing was carried out to determine the minimum inhibitory concentrations (MIC) of 16 common antibiotics to 57 strains.Results Seventeen PFGE types were identified among the 77 Salmonella strains including three predominant types (P4, P6 and P8) and were grouped into three major pulsotypes (Cluster1-3) at 90% similarity level.The predominant types causing outbreaks of Salmonella enteritidis infection were P8, P6, P4 and P14, which were responsible for five cases of food poisoning.These isolated strains were highly resistant to nalidixic acid (93%), followed by resistance towards ampicillin (74%) and streptomycin (54%).Forty-one strains were resistant to three or more antibiotics (71.93%).Conclusion The PFGE types of Salmonella enteritidis strains isolated in Longyan city exhibit polymorphism and are clustered into three major pulsotypes.PFGE molecular typing can provide early-warning of sporadic outbreaks and help to identify the sources of infections in Salmonella enteritidis-related food poisoning.Attentions should be paid to multidrug resistant Salmonella enteritidis.Surveillance for multidrug resistant strains and usage of antibiotics should be strengthened.

BACKGROUND: Models concerning tumor external environment mainly concentrated on laboratory two-dimensional culture and in vitro animal experiment, which lack of three-dimensional stereo.OBJECTIVE: To establish in vitro bone metastasis stereo models of human prostate carcinoma, and to investigate the effect of stem cells on proliferation rate and clustering size of prostate carcinoma cells. METHODS: Bone marrow mesenchymal stem cells (BMMSCs) were extracted from 2 clean grade SD rats. Alginate was used to simulate medullary microenvironment, where prostate carcinoma cells and BMMSCs were co-culturedd. Growth of the cells in the three-dimensional model was observed through microscope and histological sections. The carcinoma cells were transfected with green fluorescent protein. The proliferation of monoclonal cells clustering was observed under light microscope and fluorescence microscope. RESULTS AND CONCLUSION: In the co-culture group, the clustering speed, clustering amount and tumor formation rate were greater that those of the control group. The monoclonal cells clustering was formed at 7.75 days and 6.00 days in the control and co-culture groups, respectively, with cell counts of (95.13±11.63) and (112.53±14.67) after 10 days. The formation rate of fluorescent cell clones was (77.10±6.85)% in the control group and (64.55±6.21)% in the co-culture group, the difference had significance. The results suggested that: the alginate microenvironment is conductive to proliferation and clustering of prostate carcinoma cells and BMMSCs.

Objective To understand the status of endemic fluorosis in Shandong Province.Methods In accordance with the requirements of the National Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial) and Shandong Provincial Surveillance Scheme of Drinking-Water-Type Endemic Fluorosis (Trial),ten counties (cities,districts) were chosen in the province,and ten water-improvement projects were selected in each county (city,district).The operating effect of water-improvement projects was investigated; one peripheral water sample of each project was collected,and water fluoride content was tested.Three epidemic villages were chosen as fixed monitoring villages in each county (city,district).In the villages that had changed water source,one peripheral water sample was collected; in unchanged water source villages,one water sample was collected following five different directions of the east,the west,the south,the north and the center of the water source location; and the water fluoride content was tested.All students aged 8 to 12 were checked for dental fluorosis in the monitoring villages.The fluoride content in drinking water was detected by fluoride ion selective electrode method,and dental fluorosis was diagnosed by Dean's method.Results ① In the 10 counties (cities,districts),a total of 85 water-improving projects were monitored,and all the projects were in normal operation; the water fluoride contents of 47 projects were qualified,and the qualified rate of water fluoride content was 55.29％(47/85),with the maximum of water fluoride content was 4.74 mg/L.② In the 30 fixed monitoring villages,27 monitored villages had water-improving projects; water fluoride contents of 19 villages were qualified,the qualified rate of water fluoride content was 70.37％ (19/27),with the maximum of water fluoride content was 4.77 mg/L.In the 3 monitored villages without water-improving projects,villages of mean water fluoride contents ≤ 1.20 mg/L and ＞ 1.20 mg/L were two and one,respectively,with the maximum of water fluoride content was 1.55 mg/L.③ In the 19 monitored villages with water-improving projects that in normal operating condition with qualified water fluoride content,the detected rates of dental fluorosis and the defect type of dental fluorosis among children aged 8 to 12 years old were 52.37％(508/970) and 6.39％(62/970),respectively,and the index of dental fluorosis was 1.02.In the 8 monitored villages with water-improving projects that in normal operating condition with water fluoride content that exceeded the national standard,the detected rates of dental fluorosis and the defect type of dental fluorosis were 62.39％ (297/476) and 8.82％ (42/476),respectively,and the index of dental fluorosis was 1.67.In the 3 monitored villages without water-improving projects,the detected rates of dental fluorosis and the defect type of dental fluorosis were 49.45％ (90/182) and 7.14％ (13/182),respectively,and the index of dental fluorosis was 1.25.Conclusions In Shandong Province,the water fluoride content of water-improving defluoridation projects exceeds the national standard seriously,and water quality of the projects still need to be further improved.The projects of water-improving defluoridation play a certain role in control of dental fluorosis condition,but the condition of children' s dental fluorosis is still very serious.So preventive and control measures for endemic fluorosis should be further strengthened.

Objective:To investigate the efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mecha -nisms.Methods:The liver fibrosis rats were randomly divided into 4 groups,the model group,Silybinin meglumine 120 mg/kg group, Silybinin meglumine dose group 60 mg/kg and Silybinin meglumine low dose group 30 mg/kg,and the control group.All groups had been treated for 4 groups.Results:No deaths rat.Compared with the control group ,the reduced body weight ,less dynamic,dark hair, decreased liver and spleen indexes ,increased ALT,AST,TBIL,TG,TC and LDLC,and the decreased ALB, and the increased LXRαand SREBP1c had been observed in the model group (P<0.05).Compared with the model group ,better activity and body weight ,the in-creased liver and spleen indexs decreased ALT ,AST,TBIL,TG,TC and LDLC,and the increased ALB , and the decreased LXRαand SREBP1c had been observed in the Silybinin meglumine groups (P<0.05),in a way of dose-depended.Conclusion: The Silibinin meglumine can treat liver fibrosis ,by improving liver function,lowing lipid and decreaseing LXRαand SREBP1c expression in liver tis-sue.But the mechanism of two proteins reduced remains for further investigation .

Objective To study the prevalence of drinking water type of endemic fluorosis in Shandong Province,and to provide a scientific basis in making strategies for prevention and control of the disease.Methods Ten counties (cities,districts) were selected by random number table method to carry out the epidemiological study,and to study the progress and effect of water-improving and defluoridation projects.Three villages in each county (city,district) were chosen to determine fluoride content of drinking water and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was determined with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Deans method.Results In the 10 counties (cities,districts),a total of 515 water-improving and defluoridation projects were built covering 3 207 fluorosis villages,and the waterimproving rate was 81.71％ (3 207/3 925).A total of 85 water-improving and defluoridation projects were investigated in the 10 counties (cities,districts),and all of the projects were operating normally.The number of projects that water fluoride concentration ≤ 1.20 mg/L was 51; the qualified rate of water fluoride concentration was 60.00％ (51/85),and the maximum value of water fluoride was 4.38 mg/L.A total of 29 villages that had waterimproving and defluoridation projects were investigated in the 10 counties (cities,districts),and the number of villages that mean of water fluoride ≤ 1.20 mg/L was 21,accounting for 72.41％ (21/29); ＞ 1.20 mg/L was 8,accounting for 27.59％ (8/29),and the maximum value of water fluoride was 4.02 mg/L.In the 21 qualified villages of water fluoride concentration,a total of 1 023 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 38.12％ (390/1 023); dental fluorosis index was 0.67,and the prevalence of dental fluorosis was extremely low.In the 8 exceeding-standard villages of water fluoride content,a total of 449 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 54.79％ (246/449); dental fluorosis index was 1.18,and the prevalence of dental fluorosis was mild.Conclusion In Shandong Province,the water fluoride content of waterimproving and defluoridation projects exceeds the national standard seriously,and the condition of children's dental fluorosis is still serious,and the measures of water-defluoridation should be further strengthened.