Carcinoma ; Child ; Female ; Humans ; Nasal Polyps ; complications ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; complications

It is very important to train junior doctors'clinical skills,especially surgical skills.Operation protocol presentations before each surgical procedure provide good opportunities for them to learn these skills,and at same time,this presentation ensures a better surgical outcome as well.Each presentation is prepared under the direction of a senior doctor.A protocol is composed of the patient medical history,physical examination,accessory check up reports,diagnosis and surgical procedure.It is not only a good method for the young doctors to learn but also for their teachers to teach each student individually.

Adult ; Casts, Surgical ; Cysts ; surgery ; Ear Auricle ; Female ; Humans ; Male ; Middle Aged ; Paracentesis ; Treatment Outcome

AIM To study the role of nitric oxide (NO) and nitric oxide synthase (NOS) inhibitors during the early stage of focal cerebral ischemic injury in rats. METHODS The rat models of middle cerebral artery occlusion were established with the intraluminal suture method. The nonselective NOS inhibitor and selective inducible NOS inhibitor were used for investigating the effects of NO and NOS changes in the focal ischemic brain tissue and their respective roles during the early stage of focal cerebral ischemic injury. RESULTS This study showed that nonselective NOS inhibitors(N G nitro L arginine) aggravated brain damage in the early stage of focal cerebral ischemia and selective iNOS inhibitors (Aminoguanidine )did not significantly improve the brain damage , but could decrease markedly the deterioration of brain damage. CONCLUSION It may be concluded that the NO from defferent cells and types of NOS play unlike roles in the early stage of focal cerebral ischemic injury.

Objective: To evaluate the hemodynamic and prognostic effects of milrinone in patients undergoing valve replacement throughout the process of operation. Methods: Twenty patients undergoing valve replacement were radomized into group A ( n =10) and group B ( n =10).Before induction of general anesthesia, milrinon was administered at a 30 ?g/kg bolus dose intravenously in 10 min, followed by a continuous infusion of 0.5 ?g/(kg?min) in group A, and the same volume of normal saline in group B. The parameters of hemodynamics were obtained at the following points: before and after loading dose of milrinone, after induction of general anesthesia, after opening the chest, after weaning of CPB, before and after shutting of the sternum. The time of ICU stay and quantity of fluid in and out were calculated. Results: (1) After loading dose of milrinon, CI, LVSWI in group A were significantly higher, while PAP, CVP, SVR and PVRI were significantly lower than the same point of group B. CI, LVSWI and SVR in two groups remained significant different at the other points. (2) Patients in group A had more colloed and norepinephrine infusion than group B. Conclusion: Administration of milrinone at loading dose can effectively increase cardiac output and left ventricular stroke work, and decrease pulmonary artery pressure, pulmonary and system vascular resistance. [

Objective To establish an animal model of PCOS and to detect the DNA methylation states of LHR,INSR and AR genes. Methods 24-days-old female Sprague-Dawley (SD) rats were randomly divided into two groups. The rats in the experimental group were given subcutaneous implanting of levonorgestrel silica gel staff and injected 1.5 IU hCG twice daily for 9 days from the 4th day. The rats in the control group were injected with normal saline at the same time. Ovarian morphologic changes,sex hormone levels,fasting serum insulin and glucose were detected. The LHR,INSR and AR genes' DNA methylation patterns were checked by methylation specific PCR in modeling group and control group.Results The ovarian weight and volume in modeling group were higher than those in control group. The ovaries in modeling group showed multiple follicular cysts,and the number of theca cells and interstitial cells increased. Less developed follicles and corpus lutea were seem. The serum level of progesterone,testosterone,luteinizing hormone,fasting insulin and glucose were significantly higher in experimental group than those in control group,so as the LH/FSH ratio and HOMA index. No methylation of LHR and AR genes were found in both groups. The methylation frequency of INSR gene (76.7%) was significantly higher in modelinggroup than that in control group (P

Objective To discuss the value of MRI in the assessment of diagnosis and staging of cervical carcinoma. To compare MRI diagnosis value before surgery and pathology staging after surgery in uterine cervical carcinoma. Methods Pelvic MRI were performed in 50 patients with cervical carcinoma. The pathological type included 47 cases of squamous cell carcinoma, 2 cases of adenocarcinoma and 1 cases adeno-squamous carcinoma. The MRI scanning included axial SE T1WI, axial , sagittal and coronal FSE T2WI ,and axial , sagittal and coronal enhanced or dynamic contrast-enhanced MR. MR staging were compared with surgical pathologic staging after surgery in 38 patients. Results The accuracy of MR imaging in stage Ⅰ - ⅡA of cervical cancer were 82.35 %. These patients performed an operation of hysterectomy or subtotal hysterectomy surgery. The accuracy of MR imaging in stage ⅢA-ⅣB were 100 %. The accuracy of MRI in total stage were 84.21%. Conclusion MR imaging can show the local tumors and extension of the cervical cancer clearly on multiple planes and angles. Preoperative staging with high accuracy, MR1 is conducive to preoperative evaluation, surgical plan formulation and selection.

Objective To investigate the safety and effectiveness of digital subtraction angiography (DSA) in the surgical treatment of intracranial arteriovenous malformations (AVMs) in children.Methods Between December 2015 and February 2017,the clinical and imaging data of 9 children with AVM (2-14 years) underwent hybrid surgery at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.According to the Spetzler-Martin grade,there were 2 patients with grade Ⅰ,3 with grade Ⅱ,2 with grade Ⅲ,and 2 with grade Ⅳ.All the children were treated with microsurgery,and their AVMs were removed by real-time assistance using DSA technique during the operation.The imaging cure rate of surgical treatment and the complications of intraoperative angiography of the children were analyzed.The children were followed up clinically after procedure.According to the modified Rankin scale (mRS) score,their prognoses were evaluated.Results Intraoperative angiography revealed that the AVMs in 8 of 9 children were resected completely,and 1 had a residual lesion,then it was resected completely.Immediately after the resection of the nidi,the angiography confirmed that the nidi of 9 children were resected completely.No related complications caused by intraoperative angiography were observed.Nominal aphasia occurred in 1 child after procedure,and he recovered gradually after 6 months.Pulmonary infection occurred in 2 children,and they were cured after anti-infection treatments.Postoperative follow-up mRS scores were 0-1 in 8 children,2 in 1 child,and no rebleeding was observed.Conclusions In children undergoing AVM surgery,initial observation of DSA is safe and effective.Intraoperative angiography can guide the complete resection of the lesions in real time,improve the surgical cure rate of AVMs,and improve the prognosis of children.

Objective To establish an animal model of PCOS and to detect the DNA methylation states of LHR, INSR and AR genes. Methods 24-days-old female Sprague-Dawley (SD) rats were randomly divided into two groups. The rats in the experimental group were given subcutaneous implanting of levonorgestrel silica gel staff and injected 1.5 IU hCG twice daily for 9 days from the 4th day. The rats in the control group were injected with normal saline at the same time. Ovarian morphologic changes, sex hormone levels, fasting serum insulin and glucose were detected. The LHR, INSR and AR genes' DNA methylation patterns were checked by methylation specific PCR in modeling group and control group. Results The ovarian weight and volume in modeling group were higher than those in control group. The ovaries in modeling group showed multiple follicular cysts, and the number of theca cells and interstitial cells increased. Less developed follicles and corpus lutea were seem. The serum level of progesterone, testosterone, luteinizing hormone, fasting insulin and glucose were significantly higher in experimental group than those in control group, so as the LH/FSH ratio and HOMA index. No methylation of LHR and AR genes were found in both groups. The methylation frequency of INSR gene (76.7%) was significantly higher in modeling group than that in control group (P<0. 001). Conclusion The depression of INSR gene's transcriptional induced by DNA methylation is important in the development of insulin resistance in PCOS.

Objective To observe the effects of hydrogen sulfide (H2S) on structure and function of mitochondria of lung in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Forty healthy male Sprague-Dawley (SD) rats were randomly divided into control group, LPS injury group, and low-, middle-, and high-dose NaHS groups, with 8 rats in each group. The rats in LPS injury group were given LPS 5 mg/kg via sublingual vein, and those in low-, middle-, and high-dose NaHS groups were challenged by LPS for 3 hours followed by intraperitoneally injection of 0.78, 1.56 and 3.12 mg/kg NaHS respectively in a volume of 2 mL/kg. The rats in control group were given 2 mL/kg normal saline via sublingual vein. The rats were sacrificed at 6 hours after model reproduction, and the lung tissues were harvested on time. The mitochondria in lung tissues were isolated with differential centrifugation. The lung mitochondria ultra structures were observed with electron microscope. The content ofmalondialdehyde (MDA) in mitochondria was determined with thiobarbituric acid method, and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and adenosine triphosphatase (ATPase) were determined with xanthine oxidase method. The mitochondrial activity and swelling were determined by multiskan spectrum.Results It was shown by transmission electron microscope that the mitochondrial structure in the control group was normal. The mitochondria in rat lung cells was swollen with disrupted or disintegrated cristae, the osmiophilic lamellar bodies had fused or disappeared, and rough endoplasmic reticulum degranulation phenomenon was obvious in LPS injury group. The mitochondrial damage was slightly mitigated in the low-dose NaHS group, and it was significantly mitigated in the middle-dose and high-dose NaHS groups. Compared with control group, the MDA content in lung mitochondria in LPS injury group was significantly increased (nmol/mg: 26.30±1.45 vs. 11.16±1.20), andSOD, GSH-Px, and ATPase activities were significantly decreased [SOD (U/mg): 18.78±1.13 vs. 27.44±1.97, GSH-Px (U/mg): 63.91±1.99 vs. 128.15±3.47, ATPase (U/mg): 4.83±0.25 vs. 9.92±0.65]; as well as the activity of the mitochondria was significantly decreased (A value: 0.164±0.025 vs. 0.319±0.045), and the swelling of the mitochondria was significantly increased (A value: 0.182±0.012 vs. 0.273±0.023), all with significantly statistical differences (allP < 0.01). Compared with LPS injury group, the MDA contents in low-, middle-, and high-dose NaHS groups were significantly decreased (nmol/mg: 21.89±1.23, 17.63±1.56, 12.19±1.30 vs. 26.30±1.45), and the SOD, GSH-PX, and ATPase activities were significantly increased [SOD (U/mg): 20.13±0.85, 21.38±1.22, 24.05±1.56 vs. 18.78±1.13; GSH-Px (U/mg): 82.06±1.65, 101.45±2.14, 117.80±2.12 vs. 63.91±1.99; ATPase (U/mg): 5.34±0.23, 7.06±0.37, 8.78±0.44 vs. 4.83±0.25]; as well as the activity of the mitochondria was markedly increased (A value: 0.194±0.018, 0.230±0.032, 0.297±0.038 vs. 0.164±0.025), and the swelling of mitochondria was markedly decreased (A value: 0.195±0.008, 0.219±0.017, 0.249±0.018 vs. 0.182±0.012), all with significantly statistical differences (allP < 0.05). Moreover, the protective effect of NaHS showed a dose-dependent manner.Conclusion It could be concluded that LPS induce mitochondrial structural damage and functional impairment in rats with ALI induced by LPS, and H2S have a beneficial effect against ALI induced by LPS with decreasing the mitochondrial lipid peroxidation level and protecting the cell structure and function, and the effect is correlated with the dosage.