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.

Objective To evaluate the effectiveness of color doppler ultrasound(CDU)in combination of computed tomographie angiography(CTA)in diagnosis of the arteriosclerosis occlusion.Methods:43 patients with arteriosclerosis occlusion were assessed by color doppler ultrasound,CTA and digital subtraction angiography(DSA).By using DSA as the reference standard,the results were compared.Results The sensitivity.specificity,positive and negative predictive values for CDU were 82.96%,95.2%,94.92%,83.8% respectively.Those for CTA were 88.89%,96.75%,96.77%,88.81% respectively,and for the two combination,were 94.81%,99.17%,99.22%,94.44% respectively.Conclusion The color doppler ultrasound combined with CTA is an effective way in diagnosing arteriosclerosis occlusion.

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 explore the characteristics of narcissism in a sample of violent criminal and analyze the relationship between narcissism and impulsive-premeditated violent aggression.Methods A total of 88 violent criminal were administered by means of cluster random sampling with the Chinese version of the Impulsivepremeditated Aggression Scale and the Narcissistic Personality Questionnaire.Results (1) Comparing with the impulsive violent criminal,premeditated violent criminal had higher level of Overt narcissism,and the difference was statistically significant(59.77±10.89,54.67±10.15; P＜0.05).(2) Overt narcissism had significantly positive correlation with premeditated aggression(r=0.560; P＜0.01) ;and covert narcissism had significantly positive correlation with impulsive aggression(r=0.440; P＜0.01).(3)The authority and self-admiration traits of overt narcissism had significantly positive prediction to premeditated aggression(β=0.442,P＜0.01;β=0.297,P＜0.05);The vulnerability trait of covert narcissism has significantly positive prediction to impulsive aggression(β=0.526,P＜0.01).Conclusion Overt narcissism can result in premeditated aggression;Covert narcissism can result in impulsive aggression.

ObjectiveTo summarize the occurrence of missed diagnosis of periampullary diverticulum (PAD) with pancreatobiliary diseases and analyze its underlying reasons.MethodsWe conducted a retrospective analysis of 194 patients with PAD complicated with pancreatobiliary diseases from January 2006 to December 2011 in our hospital ResultsAt the first onset of pancreatobiliary diseases,the diagnosis of PAD was made in 48 patients (correct diagnosis group) and missed in 146patients (missed diagnosis group),with a rate of missed diagnosis of 75.3％.At the second,third and fourth onsets of pancreatobiliary diseases in the missed diagnosis group patients,the rates of missed diagnosis were 37.7％,21.8％,and 0％ respectively.There were no significant differences between the correct diagnosis group and the missed diagnosis group with respect to sex,age or the kinds of pancreatobiliary diseases (P＞0.05).But there were significant differences in the two groups with respect to different medical groups,period of admission,the frequency of application of CT,magnetic resonance (MRI) and magnetic resonance cholangiopancreatography (MRCP),duodenal endoscopy/endoscopic retrograde cholangiopancreatography (ERCP) and upper gastrointestinal contrast radiography (P＜0.05).The accuracy rates of CT,MRI,MRCP,upper gastrointestinal contrast radiography and duodenal endoscopy/ERCP for the diagnosis of PAD were 30.0％,31.5％,36.3％,64.5％ and 100.0％ respectively.At the first,second,third and fourth onset of pancreatobiliary diseases,the application rates of duodenal endoscopy/ERCP were 18.0％,33.6％,70.9％ and 91.7％,respectively.Compared with the missed diagnosis group,recurrence rate of symptom were lower significantly in the diagnosis group 1,2,and 3 years post-treatmnet.ConclusionsThe missed diagnosis of PAD complicated with pancreatobiliary diseases is rather common,mainly due to insufficient understanding for PAD.As a result,for PAD patients with pancreatobiliary diseases,the correct diagnosis rates of CT,MRI,MRCP and upper gastrointestinal contrast are low and the use of duodenal endoscopy/ERCP is insufficient.

Objective To evaluate the inverse distance weighted(IDW) in revealing the characteristics of spatial distribution of water fluoride in Heze City,Shandong Province.Methods A geographic information system (GIS) database of water fluoride was established in Heze City of Shandong Province using the data of endemic fluorosis surveys collected by Endemic Disease Prevention Institute in Shandong Province during 2005-2007.IDW spatial interpolation was applied to predict the distribution of fluoride in drinking water in 139 towns of Heze City.Sensitivity and specificity were calculated.Results Mean water fluoride levels in 10 counties of Heze City were all higher than 1.0 mg,/L,and the water fluoride in Cao County,Juye,Mudan District and Juancheng were higher than 2.0 mg/L.Of all 139 townships of Heze City,129 were higher fluoride townships where fluoride was ＞ 1.0 mg/L,10 were lower fluoride townships(≤ 1.0 mg/L).IDW spatial interpolation showed that the water fluoride of most areas in Heze City were ＞ 1.0-2.0 mg/L.The areas with water fluoride of ＞ 2.0-3.0 mg/L were mainly located in eastern Juancheng,northern Mudan District,north-central Chengwu,central and southern Juye,southeastern part of Caoxian and eastern part of Shan Town.Regions of water fluoride ＞ 3.0 mg/L were mainly distributed in Xieji and Wanfeng towns of Juye County,Jishan town of Juancheng County,Sunlaojia town of Caoxian and Dusi town of Mudan County.The internal verification results showed that the sensitivity,specificity and overall accuracy rate of IDW used for predicting water fluoride content was 100.00％ (129/129),10.00％ (1/10) and 93.53％ (130/139),respectively.While the external verification results showed that the sensitivity,specificity and overall accuracy rate of IDW for predicting water fluoride content was 100.00％(31/31),11.11％(1/9) and 80.00％(32/40),respectively.Conclusion With the application of IDW interpolation,it is feasible to infer the overall spatial distribution based on the monitoring data,and to reveal the spatial characteristics of water fluoride in Heze City,Shandong Province.

ObjectiveTo investigate the clinical efficacy of gentle moxibustion in treating old interphalangeal collateral ligament injury.MethodSixty patients were randomly allocated to two groups. The treatment group of 30 patients received gentle moxibustion 20-30 min once daily for two consecutive courses of treatment. The control group of 30 patients received TDP irradiation 20-30 min once daily for two consecutive courses of treatment.ResultThe excellent rate and the total excellent rate were 56.7% and 83.3%, respectively, in the treatment group and 36.7% and 76.7%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.01).ConclusionGentle moxibustion has a marked therapeutic effect on old interphalangeal collateral ligament injury.

Objective To explore the relation and measures prevention between aspirin and relapsing haemorrhage after operation in cerebral haemorrhage patients. Method It' s a prospective control study. A total of 725 patients with hypertensive basal ganglia cerebral haemorrhage admitted to department of neurosurgery from January 2001 to May 2007 were enrolled. They were diagnosed according to the diagnostic criteria set by the fourth national cerebrovascular disease conference in 1995. Haematoma volume was ＞ 50 mL. All patients were treated with craniotomy. And those with respiration and circulation failure, neurologic function deficit before the onset of the disease,major organ dysfunction, haemorrhagic disease and bleeding tendency or applied medicines affecting coagulation function excepted aspirin were excluded. The patients without use of aspirin before the onset of the disease were operated as the control group(group A), and there were 389 patients in group A.The patients with use of aspirin before the onset of the disease were randomly assigned to group B and C group,and there were 168 patients in group B or group C.The patients in group C received the frozen apheresis platelets. We counted different haematoma volume of relapsing haemorrhage after operation,death rate,ADL scores grades by 6 months follow-up survey in three groups. Quantitative data were expressed as mean ± standard deviation (-x ± s). The data were analyzed by using Chi-square test and Student's t test and rank sum test with SPSS 13.0 statistical package. A P value less than 0.05 indicated statisticals significance. Results Haematoma volume of relapsing haemorrhage was (40.59 + 20. 061 )mL, (53.21 ± 21.260) mL, (40.68 ± 19.517) mL in groups A, B, C,respectively. There was significant difference between group A and group B ( P ＜ 0.01 ), between group B and group C ( P ＜ 0.05), but there was no significant difference between group A and group C(P ＞ 0.05). ADL scores grades at 6-month follow-up was (67.04 ± 26. 176), (54.47 ± 29.403 ), (68.21 ± 25.254) in groups A, B, C, respectively. There was more significant difference between group A and group B, in ADL scores grades and the death rate between group B and group C (P ＜ 0.01), but there was no significant difference between group A and group C (P ＞ 0.05). Conclusions Aspirin can increase the occurrence rate of haemorrhage after operation, disablement and death in cerebral haemorrhage patients, but frozen apheresis platelets can reduce the occurrence rate.

Objective To detect the methylation status of gastric cancer tissue genome by DNA methylation chip. Methods Methylation status of 6 samples of gastric cancer tissues and their matched adjacent tissues was analyzed using methylated DNA immunoprecipitation ﹙MeDIP) combined with NibleGen chip. Significantly different methylated genes in promoter region and CpG island between two tissues were searched. Functions of these significantly different methylated genes were analyzed by Gene Ontology and Pathway assays. Results In gene promoter regions, 113 significantly different methylated genes were identified in gastric cancer tissues, such as SHP1, FGF8 and CSF2RA, while 161 significantly different methylated genes were identified in their matched adjacent tissues, such as TNF, IGF2 and BMP7. In the CpG islands, 123 significantly different methylated genes were identified in gastric cancer tissues, such as WNT2B, JAK2 and TPT1, while 139 significantly different methylated genes were identified in their matched adjacent tissues, such as TNFRSF4, HOXC8 and NFYA. These genes located on different chromosomes. In gastric cancer tissues, the 1st and the 4th chromosomes had the most ﹙both 11), the 18th and the 20th chromosomes had the least ﹙both 1). In matched adjacent normal tissues, the 9th, 19th and 20th chromosomes had the most ﹙11), and no significantly different methylated gene was found on Y chromosome. These genes involved in many functions, such as protein phosphorylation, regulating cellular catabolism, ion transport, enzyme activity, transcriptional regulation, cell division, cell cycle regulation, and signal transduction. Conclusions There are significant differences between gastric cancer tissues and their matched adjacent tissues in DNA methylation. DNA methylation genes locate on different chromosomes, and their number and distribution vary widely. These genes may be associated with many pathways in carcinogenesis.

Objective To evaluate the radiation dose from a dual energy X-ray absorptiometry (DXA) study. Methods A Radcal multifunctional dosimeter (1800 cc ionization chamber, USA) was used, for purpose of comparison, to measure the entrance surface doses (ESD) from Norland XR-800 DXA ( pencil beam scan, 100/46. 8 kVp, 1. 3 mA) and from Hologic Discovery A DXA ( fan beam scan, 140/100 kVp, 5. 0 mA) . Ambient dose equivalent rate at 1 m away from studied phantom center and at 1 m above floor was measured using the US 451P ionizaion chamber survey meter ( Fluke, USA). Results The ESD measured using a Radcal dosimeter for Norland XR-800 DXA was 0. 43 μGy in high speed mode and 0. 73 μGy in standard mode ( AP spine ) , 1. 93 μGy ( hip ) , 0. 40 μGy ( wrist ) and 1. 06 μGy ( mandible) . The ESD measured for Hologic Discovery A DXA was 65. 6 μGy ( AP spine) and 63. 9 μGy ( hip) . The ESD measured for Norland XR-800 at different scan types and scan speeds was <2 μGy while Hologic Discovery A DXA showed a result of <66 μGy ( AP spine and hip scan ) , which were both consistent with the data given in their own respective operational manual. A comparison of DXA scanners with fan beam and pencil beam indicated that ambient equivalent dose rate, measured with 451P survey meter, from fan beam scan was 65 times that from pencil beam scan. Conclusions Compared with other medical X-ray studies, the ESD to the phantom undergoing a DXA study is relatively low. DXA pencil beam scan doses to lumbar spine and hip were about 1/153-1/33 of those from DXA fan beam scan. Pencil beam scan dose to DXA staff was negligible and fan beam scan dose to DXA staff was lower than the personal dose limits of 20 mSv per year.