OBJECTIVE To study the causes of recurrence and treatment methods in patients with recurrent sinonasal melanoma. METHODS From 1993 to 2003, a retrospective analysis of consecutive 11 cases with recurrent sinonasal melanoma was conducted. RESULTS Four out of the 11 cases with recurrent sinonasal melanoma were caused by misdiagnosis, while the other 7 cases recurred after operation with pathological diagnosis. Among the 7 cases, 5 were found recurrences after operation alone, and the other 2 after the operation and radiation therapy. The recurrence lesions located in nasal and paranasal sinus in 7 cases, in orbit, skull base, soft and hard palate in 1 case, in parotid gland and skin in 1 case. In face, orbit and extended skull base in 1 case. Cervical lymph node recurrence developed in 1 patient. The time of first relapse was 10 months after therapy. The 1-, 2-and 3-year survival rates after reoperation were 72.7 %, 18.2 % and 9.1 % respectively. CONCLUSION The reasonable treatment and decrease the misdignosis are the main measures to improve the cure rate of recurrent sinonasal melanoma.

Objective To analyze the treatment and pathogenetic condition of chronic heart failure of coro -nary heart disease(CHD) and ventricular arrhythmia (VA).Methods 100 patients with chronic heart failure were collected to observe the treatment of chronic heart failure and pathogenetic condition of VA .Results 44 cases occured VA and 56 cases without VA in 100 patients.NT-proBNP(3 110.00 ±522.00)pg/mL of VA group was sig-nificantly higher than that (2 200.00 ±486.00)pg/mL of non-VA group(t=8.996,P<0.05).LVEF(0.25 ± 0.08) of VA group was lower than that of non -VA group(0.41 ±0.98) (t=11.625,P<0.05).The occurrence (100.00%) of premature ventricular contraction ( PVC) of ≥70mm group in left ventricular internal diameter (LVID) was higher than that of 60 -69mm group (60.87%),50 -59mm group (37.04%),40 -49mm group
(15.38%) with statistically significant(χ2 =5.853,12.532,27.375,all P<0.05).The amount(44.20 ±12.90)mg of use βreceptor blockers of amiodarone group was significantly lower than that of non -amiodarone group(44.20 ± 12.90)mg (t=5.284,P<0.05).Conclusion NT-proBNP of CHEF of CHD and VA patients will improve and amiodarone can reduce the amount of use anti -heart failure drug .

Objective To investigate the changes of heart function after pacing in right ventricular inlet septum(RVIS) and right ventricular apex(RVA). Methods VVI pacing was performed in 64 patients who were randomly divided into two groups: RVIS group (33 patients) and RVA group (31 patients). The changes of serum brain natriuretic peptide (BNP),pacing parameters and QRS interval were assessed in 24 hours, 3 months and 1 year after the ventricle was paced effectively. Results When the ventricle was paced effectively,the pacing parameters,including voltage threshold and electrode impedance were similar in different stages between the two groups. In 24 hours, 3 months and 1 year after the ventricle was paced effectively,the QRS interval in RVIS group were obviously narrower than those in RVA group [( 128.0±28.6 ) ms vs ( 150.0 ± 37.1 ) ms, ( 131.0±21.5 ) ms vs ( 153.0 ±28.5 ) ms, ( 130.0 ±19.7 ) ms vs ( 155.0±20.2) ms, P < 0.05 ]. After treatment, the level of serum BNP increased significantly in two groups. The BNP level in R VIS group was significantly lower than that in RVA group (P < 0.05). Conclusion The R VIS pacing is not only as safe and effective as RVA pacing, but also is more consistent with the physiological ventricular activation sequence.

Objective To study the serum free carnitine level and change trend in premature infantwith hyaline membrane disease (HMD) within postnatal 7 d .MethodTotally 63 preterm newbornwith gestational age of 28-32 weekin the NICU of thihospital were selected ,among them 32 caseof HMD were taken athe observation group and othe31 preterm newbornwithouHMD athe control group .The free carnitine level wameasured within 6 h aftebirth ,on 3 ,7 d by using the tandem masspectrum method .ResultThe free carnitine level within 6 h aftebirth had no statistical difference between the observation group and the control group[(23 .57 ± 7 .45)μmol/L v.(24 .34 ± 5 .73)μmol/L ,t=0 .48 ,P=0 .630] ,the free carnitine level on 3 d in the observation group wasignificantly lowethan thain the control group [(19 .21 ± 6 .83)μmol/L v.(23 .74 ± 7 .13)μmol/L ,t=2 .57 ,P=0 .010];the free carnitine level on 7 d in the observation group waalso significantly lowethan thain the control group [(16 .62 ± 7 .95)μmol/L v.(22 .83 ± 6 .56)μmol/L ,t=3 .39 ,P=0 .001] .The free carnitine level aftebirth in the control group remained stable ,which a3 time pointof 6h ,3 ,7 d had no statistical difference(F=0 .42 ,P=0 .660);whereathe free carnitine level wagradually decreased aftebirth ,which a3 time pointof 6 h ,3 ,7 had statistical difference(F=7 .13 ,P=0 .001) .Conclu-sion The free carnitine level aftebirth in preterm newbornwith HMD igradually decreased ,which needmore carnitine fopromoting the generation of pulmonary surfactan.

Objective To evaluate the diagnostic accuracy of dual source CT angiography (DSCTA) for coronary artery stenosis.Methods During the period from November 2012 to November 2013, a total of 210 patients with coronary artery disease underwent DSCTA and selective coronary arteriography (CAG). Taking CAG as the gold standard, the diagnostic accuracy of DSCTA for coronary artery stenosis was evaluated. Thirty patients receiving DSCTA and 30 patients receiving CAG were selected, and all of them underwent stent implantation in the anterior descending branch after imaging examination. The angiography positions, the used time of PCI and the used dosage of contrast agent were compared between the two groups. Results DSCTA was performed in 210 patients and a total of 2 630 segments of coronary stenosis or occlusion were detected. Compared with CAG, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of DSCTA were 95.4%, 96.2%, 91.3%and 100%respectively, which were not significantly different from those obtained by CAG (P=0.066). In performing DSCTA, 2-3 angiography positions were used (2-4 positions less than that of CAG), the used time of PCI was about 15 min (about 10 min less than that of CAG), and the mean used dosage of contrast agent was 48 ml (30-150 ml) (about half less than that of CAG). Conclusion DSCTA has higher accuracy in diagnosing coronary artery stenosis, quite similar to that of CAG. DSCTA is a safe, reliable and noninvasive examination method. Preoperative DSCTA can reduce exposure positions during angiography, can reduce the dosage of contrast agent, and can shorten the time of PCI as well, thus, iatrogenic radioactive radiation dose can be reduced.

Growth stimulating gene 2 (ST2) protein is a member of the interleukin-1 receptor family. It is mainly divided into a soluble secreted form sST2 and a transmembrane form ST2L. sST2 is a decoy receptor that competitively binds to interleukin-33 to block the interleukin-33/ST2L signaling pathway, worsening myocardial hypertrophy, fibrosis, and ventricular dysfunction. Measuring sST2 is of important value for diagnosis and/or prognosis evaluation of cardiovascular diseases. This paper mainly reviews the research progress in the relationship between cardiovascular diseases such as heart failure, coronary heart disease, hypertension, atrial fibrillation, myocarditis, cardiomyopathy, acute aortic dissection, and pulmonary hypertension, and sST2.

Objective To study the possible mechanism of hearing impairment after noise exposure .Methods Adult SD rats (n=14) were monaurally exposed to a loud noise (16 kHz ,one octave band pass (116 dB SPL)) for 1-hour ,or left as non-exposed controls (n=8) .The ABR was measured before and on the 7th day following unilateral noise exposure .All the Animals were euthanased at 7th day following acoustic trauma .We used Western blots to quantify protein levels of PV ,CR and CB in the inferior colliculus .Results The auditory thresholds in 8 , 12 ,16 ,20 ,24 ,and 32 kHz of all the ears exposed to noise showed a significant increase (P<0 .001) .Compared to the sham -exposed controls ,noise-exposed animals had significantly higher levels of PV and CR and lower levels of CB in both the ipsilateral and contralateral IC than controls (P<0 .05) .Respectively ,all the noise-exposed ani-mals had higher levels of PV and CR in the ipsilateral IC than ipsilateral side (P<0 .05) .Conclusion These studies display a significant threshold shift and changes on the expressions of PV ,CR and CB in IC following acoustic trau-ma ,which may be related to noise deafness ,tinnitus and other series of auditory dysfunction .