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 To investigate the effect of hexosamine biosynthesis pathway on the development of insulin resistance induced by high fat diet.Methods Normal male SD rats were randomly divided into three groups:control(fed with normal chow),high fat(fed with high fat diet for 13 weeks),and rosiglitazone (intragastric administration with rosiglitazone for 5 weeks)groups.After 13 weeks,all the rats were sacrificed,serum and muscle triglycerides(TG),serum total cholesterol(TC),and serum and muscle free fatty acids(FFA) were measured.Insulin sensitivity wss evaluated by insulin sensitivity index(ISI)and glucose infused rat(GIR) with the hyperinsulinemic englycemic clamp technique.The flux of HBP in skeletal muscle was detected with the expression level of glutamine-fructose-6-phosphate transaminase(GFAT)mRNA(RT-PCR),the content of UDPGlcNAc(HPLC)and the level of O-GlcNAc glycosylation in skeletal muscle proteins(Western blot). Results Compared with control group,senlm TG,TC,FFA and muscle TG,FFA levels of high fat group increased(aII P<0.01).both ISI and GIR decreased(both P<0.01),and the leveIs of GFAT mRNA(0.51±0.05 vs 0.18±0.02),UDP-GlcNAc[(6.18±0.86 vs 2.42±0.36)nmol/g],and O-GIcNAc glycosylation of skeletal muscle proteins in high fat group were raised(all P<0.01).In rosiglitazone group,serum and muscle TG.FFA welc deceased(all P<0.01).insulin sensitivity was increased(P<0.05)and the flux of HBP[GFAT mRNA 0.27±0.03,UDP-GIcNAc(2.62±0.32)nmol/g]was reduced(all P<0.05)as compared with high fat group. Conclusions High fat diet-induced insulin resistance in rats is correlated with the increased flux of HBP in skeletaI muscle.which is decreased by rosiglitazone.

Objective To evaluate the availability and sensitivity of MR whole body diffusion weighted imaging (DWI) in searching primary tumors in patients with metastases.Methods Thirty-four patients with symptoms of metastases and unknown primary leasions were scanned by whole body DWI.All the metastases cases were diagnosed by CT,single photon emission computed tomography(SPECT) or MRL For the cases of suspected primary tumors,apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively.For the cases with primary lung cancers and metastases proved by pathology of biopsy or surgical specimens,statistics analysis of ADC values of primary and metastatic lesions was performed with paired samples t-test.The detection rate and sensitivity of this technique for screening primary tumors were evaluated.Results By whole body DWI,24 cases were found with suspected primary lesions,in which 23 cases were proved primary tumors,and 1 case was proved benign lesion.Ten cases were not identified with primary lesions on whole body DWI,but in which 2 cases were proved primary malignant tumor by biopsy later,and the other 8 cases remained unknown within follow-up of half a year to one year.For the 14 definite cases of lung cancers,the average ADC values of primary and metastatic lesions was (1.24±0.18)×10-3 and(1.16±0.27)×10-3mm2/s,respectively (t=1.28,P>0.05).The detection rate and sensitivity of whole body DWI for searching primary tumors was 67.6% (23/34) and 92.0% (23/25),respectively.Conclusion The sensitivity of whole body DWI for searching primary tumors is relatively high,and it can be used to search primary tumors in patients with metastases.