Objective To evaluate CT manifestations and its clinical significance of the laryngopharyngeal carcinoma.Methods CT findings of 18 cases with laryngopharyngeal carcinoma proved by surgery and pathology were analysed.Results Of 18 cases,11 cases were in the piriform fossa,5 cases were in the postcricoid region and 2 cases were in the posterior wall of laryngeal pharynx.The tumor showed isodense or mixed density and slightly enhancement.It was the characteristic feature of the laryngopharyngeal carcinoma that the tumor pushed the annular and arytenoid cartilage displacement anteriorly,the thyroarytenoid gap and cricothyroid joint were widened.Other indirect findings included invasion of the larynx and esophageal ostium,destruction of laryngeal cartilage and metastasis of lymph node of neck.Conclusion CT can reliably exhibit the location,size and extent of the tumors and metastasis of lymph node of neck.It is useful in working out the thearapeutic program and evaluating prognoses.

OBJECTIVE: To raise awareness of granulomatosis with polyangiitis by summarizing its nasal mani- festations and treatment experience. METHOD: Retrospective studies were done to the nasal clinical manifestations and treatment processes of 21 GPA patients in this study. All were treated by the combined treatment of glucocorticoid, cyclophosphamide as well as tripterygium wilfordii, and 4 of them who had much heavier nasal symptoms were treated by endoscopic sinus operation at the same time. RESULT: Eighteen cases were effective treated by medical treatments besides 3 were died of all 21 cases. The nasal symptoms of those 4 patients were obviously improved, and still had effective drainage of sinus after operation with 8-22 months follow up, although the sinus ostiums were reduced comparing to themselves intraoperation at different degree. CONCLUSION GPA is always been ignored which will lead to delay treatment due to the lack of specificity of its clinical manifestations. So, enough attention is the key point of avoiding misdiagnosis as well as providing timely treatment for these patients.
Combined Modality Therapy ; Diagnostic Errors ; Drainage ; Endoscopy ; Granulomatosis with Polyangiitis ; complications ; diagnosis ; therapy ; Humans ; Nose ; Paranasal Sinuses ; Retrospective Studies

Patient, 30-year-old, male,was admitted to our hospital because of discontinuously spit fresh blood without any inducing factors for three days. In the course, the patient suffered mild dry sensation of pharyngeal, poor spirit condition, fatigue, poor sleep, poor appetite and was with black stool 2 times. Physical examination: T36. 6°C, R 21/min, P98/min, BP135/90 mmHg (1 mmHg = 0.133 kPa). Bilateral tonsils were III hypertrophy and with scar shape surfaces. The left tonsil's surface had longitudinal small blood vessels markedly dilated. His oropharynx, laryngopharynx and laryngeal did not be find any obvious bleeding sites. Laboratory findings: WBC 13.82 x 10(9)/L, N 0.8084, L 0.1632, Hb 81.00 g/L, HCT 25.20; PT 9.60 s, APTT 25.50 s, TT 15.80 s, FIB 1.900 g/L. After 3 hours of admission,the patient spit out fresh blood again,checked the body to see:the left peri-tonsil with fresh blood and found a slowly bleeding site at the 1/3 junction of the middle lower part of left tonsil's rear surface, the size was about 0.5 cm x 0.6 cm. We finally diagnosed spontaneous tonsillar hemorrhage and successfully managed with low-temperature radiofrequency technology.
Adult ; Catheter Ablation ; Hemorrhage ; therapy ; Humans ; Hypertrophy ; Hypopharynx ; Larynx ; Male ; Oropharynx ; Palatine Tonsil ; pathology ; Temperature

Objective To observe the clinical efficacy ofWuzi Yishen Oral Liquid for female stress urinary incontinence.Methods Ninety patients were randomized into treatment group (45 cases) and control group (45 cases). The treatment group was treated byWuzi Yishen Oral Liquid, while control group was treated bySuoquan capsule. After three-month treatment, the clinical efficacy was observed by 1 h pad-test and urinary incontinence questionnaire scores.Results Compared with before treatment, the quantity of fluid loss of 1 h pad-test of the two groups was reduced significantly, and the symptom scores of urinary incontinence questionnaire were improved after treatment (P<0.05). The symptom scores of urinary incontinence questionnaire of the treatment group were higher than the control group (P<0.05).ConclusionWuzi Yishen Oral Liquid has obvious clinical efficacy for the treatment of female stress urinary incontinence.

Polymerase chain reaction(PCR) was used for the first time in China for the diagnosis of cryptococcal meningitis by amplification of specific sequence of the rDNA genes of C.neoformans.All 11 strains of C.neoformans yielded a specific 136 bp fragment but 21 non-C,neoformans strains did not. The sensitivity of the amplification was about 10 cfu.With the aid of the rDNA-PCR,23 of the 23 cere- brospinal fluids (CSF) specimens which had been confirmed C.neoforrnans positive by smear and/or cul- ture were PCR-positive(100%),and 13 of the 14 CSF specimens which had been confirmed C.neofor- mans negative by smear and culture were PCR-negative (93%).The results of the present study suggest that rDNA-PCR is a sensitive and specific method for rapid diagnosis of cryptococcal meningitis.

Objective To explore the therapeutic effects of isokinetic eccentric exercise (IEE)in patients with knee osteoarthritis. Methods Forty patients, including 70 knees with osteoarthritis, were measured and trained by use of Cybex-6000 and its isokinetic exercise system 3 times per week for 4 weeks. The peak of moment, single largest work, average power and accelerate energy of moment of isokinetic speed in 60?/s、120?/s and 180?/s were measured before and after exercise. The scores of pain and lower limb function were compared before and after IEE. Results The parameters of extensor and flexor groups were significantly increased after exercise, especially the parameters of knee flexors. The scores of pain and lower limb function were also improved. Conclusion IEE could improve effectively the function of knee extensors and flexors in patients with knee osteoarthritis, and relieve the pain.

Objective To investigate the effects of robot-assisted walking training after total knee replacement (TKR).Methods Forty TKR patients at 1 week post-operation were randomized into a control group (n =20) and a treated group (n =20).For 2 weeks the control group accepted routine rehabilitation therapy.The treated group received the same treatment as the control group,but also walking training using a robot-assisted walking training system.The results were evaluated using the Hospital for Special Surgery knee rating scale (HSS),knee proprioception grading,Berg scores,and 6 minute walking distance in both groups.All the analyses were administered before the operation and 2 weeks,l month,3 months and 12 months after the operation.Results The treated group had significantly better HSS scores,Berg scores,and 6 minute walking distances than the control group on average.However,there was no significant difference in average knee proprioception between the two groups.Conclusion Robot-assisted walking training was significantly more effective than conventional rehabilitation alone in improving knee joint function,balance ability and walking after TKR.

At present, the teaching management department is facing a big puzzle in the education of medical professional postgraduate degree. How to strengthen the appropriate scientific research training while successfully completing the 33-months clinical rotation. With the social development and increasing demands, the original training model that training professional technical personnel and scientific academic personnel seperately has been confirmed unable to adapt to the current requirements. Combining with the practi-cal experience of the medical postgraduate degree education, we put forward some constructive suggestions of boosting the innovation of the medical postgraduate degree education from several aspects, such as optimizing the training process, strengthening the stage man-agement, improving the quality of the tutor team, smoothing the communication mechanism between teachers and students, cultivating clinical research thinking, etc.

Objective Alstr(o)m syndrome (AS) is a rare,autosomal recessive inherited disease characterized by various clinical manifestations.The aim of this study was to review the clinical characteristics and laboratory findings of AS.Methods Two cases of AS was reported.Combined with the clinical data of 7 cases of AS which had been reported in China,the clinical characteristics and laboratory findings of AS were reviewed.Results Visual disorder( median onset age:6.0 years ) and dysaudia( median onset age:10.3 years ) were found in 9 patients,short stature and obesity in 8 patients,acanthosis nigricans in 7 patients,diabetes mellitus( median onset age:14.5 years) in 6 patients,and heart disease in 4 patients; hyperuricemia was detected in 6 patients,hepatic dysfunction and hypertriglyceridemia in 5 patients.Conclusions Visual disorder was the first presentation in patients with AS.Deafness,obesity,diabetes,and short stature were common.These findings were helpful in making an early and accurate diagnosis and appropriate treatment.

Objective To analyze the literatures on arthroplasty treating femoral neck fracture in the elderly so as to evaluate the value of arthroplasty in treating femoral neck fracture in the elderly. Methods The literatures published from 1991 to 2007 on arthroplasty treating femoral neck fracture in the elderly were retrieved via PubMED and Ovid database to compare the mortality. Dislocation, revision and Harris score after operation. The heterogeneity was tested and the data dealt by meta-ana]ysis. Then, we talculated the OR value and 95% confidence interval. Results The study included 10 related pa-pers involving hemi-arthroplasty(HA)and total hip arthroplasty(THA)treating femoral neck fracture in the elderly. There was no statistical difference between HA and THA in aspect of mortality. No heteroge-neity existed in dislocation and revision, with the Q value of 4. 03 and 2. 78 respectively(P>0. 1). THA had a high dislocation rate but lower incidence of revision, in comparison with HA. The heterogeneity of Harris score was confirmed with the Q value of 23. 94(P<0. 1), with relative risk(RR) of 0. 79, OR of 0. 35 and 95% CI of 0. 23-0. 53. Conclusions As for hip function recovery, THA is better than he-mi-arthroplasty and THA should be the first choice for femoral neck fracture. However, for patients who can not tolerate operation or have anticipated life span less than 5 years, hemi-arthroplasty should be cho-sen.