Objective To analyze CT findings of blunt laryngeal trauma (BLT) and evaluate the value of CT in the diagnosis of BLT. Methods CT diagnosis and treatment of 16 patients with BLT were reviewed. Results Soft tissue injuries were detected in five cases including swelling of the aryepiglottic folds, the false or true vocal cords and airway narrowing in four, and left cricoarytenoid dislocation and card paralysis in one. Supraglottic injuries in two cases including c fractures of the epiglottis in 2 and associated with a laceration of the aryepiglottic folds and the hypopharynx. Glottic injuries in four cases including ventricle fracture of the right thyroid ala in one and midline ventricle or comminute fractures of the thyroid cartilage in three, a square segment of cartilage was depressed into the larynx, and the true vocal cords and the anterior commissure were disrupted in one of this series. Subglottic injuries in five cases including cricoid ring fracture on the opposite side following a lateral force in one, with the fragment depressed into the larynx. Two showed marked comminution of the cricoid ring. Midline vertical fracture of the posterior cricoid plate associated with the laceration of the first tracheal ring in one, and one presented marked disruption of the right cricothyiod joint. Conclusion CT clearly shows the extent of cartilaginous injury and displacement, related soft tissue changes and the degree of resulting airway encroachment, and it may be successfully used to determine the need for open exploration and repair in selected cases of blunt trauma to the larynx.

BACKGROUND: Herterologous antigen has strong immunogenicity and easily induces immunological response. Introduction of herterologous antigen into tumor may induce a serial of immunological reactions in the tumor and may reverse the immunosuppression of tumor microenvironment to treat tumor.OBJECTIVE: To evaluate the antitumor efficacy of intratumoral injection of human erythrocyte membrane antigens in micebearing S180 sarcoma.METHODS: Kunming mice bearing S180 sarcoma model were established and treated with 5 g/L human erythrocyte membrane antigens suspension or normal saline for five days. Tumor volume was calculated before the first injection and 3, 7, and 14 days after the first injection. In addition, the tumor cells in combination with human erythrocyte membrane antigens group, the njectionof saline group (the control group), and the injection of human erythrocyte membrane antigens or saline group (pre-immunized by suspension of human erythrocyte of blood group type A). Another 60 mice bearing S180 sarcoma were established and subjected to the above pre-immunization and injection of saline or human erythrocyte membrane antigens. Six mice selected from each group were sacrificed 14 days after the first injection, and tumors were weighed, followed by histological examination. Survival of remainders in each group was observed.RESULTS AND CONCLUSION: Tumor volumes in each group increased gradually. Tumor volumes in the human erythrocyte membrane antigens injection group, the tumor cells in combination with human erythrocyte membrane antigens group, and the human erythrocyte membrane antigens injection group (immunized) were smaller than the control group, Intratumoral injection of human erythrocyte membrane antigens significantly reduced tumor weights. Tumor necrosis, infiltration of inflammatory cells such as lymphocytes were observed in tumor tissues section examination following the intratumoral injection of human erythrocyte membrane antigens. The mouse survival time showed no statistical difference among different groups. Intratumoral injection of heteroloaous ervthrocvte membrane antiaens can inhibit tumor arowth of S180 sarcoma bearina mice.

Replenishing the insulin-producing β cell mass is considered to be a hot topic in the field of diabetes treatment.It has long been known that pancreatic β cells are generated primarily by self-duplication in adults.However,insulin resistance can induce dramatic compensatory β cell mass expansion in the pancreas.Therefore,it is of great value to investigate the etiology and pathogenesis of β cell proliferation under insulin resistance.The recent study has shown that betatrophin,a protein secreted by the liver,modulates β cell growth in response to insulin resistance.We published one article in Diabetes Care titledIncreased circulating levels of betatrophin in newly diagnosed type 2 diabetic patientsto elaborate the relationship between diabetes and betatrophin.

This study was aimed to explore the mechanism ofZi-Bu Pi-Yin Recipe (ZBPYR) on autophagy and endoplasmic reticulum stress (ERS) to improve spleen-yin deficiency diabetes-associated cognitive decline (DACD). Rats were randomly divided into the control (cont) group, the diabetes (DM) group, the spleen-yin deficiency (pi) group, the spleen-yin deficiency diabetes (piDM) group, and the spleen-yin deficiency diabetes + ZBPYR treatment (ZBPYR) group. The expression of microtubule-associated protein 1A/1B-light chain 3 (LC3Ⅱ), inositol-requiring enzymeα (IRE1α), c-Jun N-terminal kinase (JNK) were observed by western blot. The results showed that the expression of LC3Ⅱ in the DM group, pi group and piDM group decreased compared with the cont group (P < 0.05); and the expression of LC3Ⅱ of the ZBPYR group increased compared with the DM group and piDM group (P < 0.05). Compared with the cont group, the p-IRE1α of the DM group and piDM group, as well as p-JNK1 in the pi group and piDM group were increased (P < 0.05). The p-IRE1α and p-JNK1 of the ZBPYR group were decreased compared with the DM group and piDM group (P < 0.05). It was concluded that ZBPYR improved spleen-yin deficiency DACD by regulating autophagy and ERS.

BACKGROUND:In the past 20 years, cholecystokinin in clinical application and nerve repair has been extensively studied. OBJECTIVE:To explore the role of cholecystokinin in nerve repair and its possible mechanism of action. METHODS:Relevant research results were retrospectively analyzed at the celland organ levels through retrieving recent literatures concerning the biological characteristics of cholecystokinin and its biological role in the nervous system. Then, we summarized the effect of cholecystokinin after nerve injury and its possible RESULTS AND CONCLUSION:Cholecystokinin and its receptors are widely distributed in the body, and under physiological and pathological conditions, their roles were complex and diverse. However, studies addressing the neuroprotective effect of cholecystokinin are not sufficient, most of which are limited to phenomenon observation. Neuroprotective mechanism of cholecystokinin is stil worthy of further studies, which can provide the basis for the clinical application.

Objective: To retrospectively characterize and analyze the thyroid ultrasound images of thyroid cancer patients, to classify thyroid nodules according to thyroid imaging reporting and data system (TI-RADS), and to evaluate the diagnostic value of TI-RADS. Methods:Clinical data of 160 thyroid cancer patients with 235 nodules from September 2008 to August 2011 were retro-spectively analyzed. All patients underwent conventional color Doppler ultrasonography to evaluate the size, number, shape, boundary, and extent of lesions and blood distribution of the nodules. All nodules were analyzed according to TI-RADS classification and scored to evaluate the diagnostic value of TI-RADS. Results:Among 176 malignant nodules, 144 (81.8%) had lesions showing a mass of irreg-ular boundary with no envelope and halo, 152 (86.4%) were inhomogeneous hypoechoic or slightly hypoechoic, or 144 (81.8%) exhibit-ed microcalcification. TI-RADS scores of 4 or 5 and 2 or 3 were obtained in 160 (90.91%) and 16 (9.09%) of the malignant nodules, re-spectively. Conclusion:Thyroid ultrasound sonogram of ill-defined, irregular shape, hypoechoic or slightly hypoechoic mass, microcal-cification within the mass, and rich blood flow is an important index for the diagnosis of thyroid cancer. Thyroid nodules with a TI-RADS score 4 or 5 have higher possibility for cancer. Therefore, TI-RADS has a significant diagnostic value for thyroid cancer be-fore operation.

Objective To investigate the effects of the teaching model of team-based learning (TBL) in the course of TCM Basic Theory.MethodsTotally 61 undergraduates of Class 1-2 in Grade 2013 in Dalian Medical University are divided into 15 groups, three to five students in each group. TBL teaching model was performed in the chapter about Zang-Fu relationship in the course of TCM Basic theory. At the end of the study, the students received the questionnaire survey to know the effects of TBL teaching model.ResultsStudents discussed intensely with lively atmosphere in the class. The pass rate of individual test was 98.36%, and the excellence rate was 22.95%. The results of immediate feedback answer sheets showed that for the 6 multiple choice questions, each group answered at least 2 questions correctly for the first time, and 5 groups answered all the questions correctly for the first time with the joint efforts of group members.ConclusionTBL teaching model could promote the preview, activate atmosphere in class, improve learning efficiency, and increase the solidarity and collaboration in students.

Objective To assessed the distribution of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in Xinjiang Uygur and Han nationality populations,and to investigate correlation and the incidence of all cases of macrovascular disease (coronary artery disease,carotid atherosclerosis and peripheral arterial disease)and analysis of risk factors.To further study the correlation between the incidence of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in type 2 diabetes melli-tus(T2DM)of Han and Uygur ethnic and the incidence of all cases vascular disease,then to analysis the risk factors. Methods 497 adults with T2DM who were treated in the Endocrinology department in hospital from May 2012 to April 2014 were involved in this study,including 298 Uygur patients and 199 Han patients.215 non -T2DMpatients who were treated in the Cardiology department in hospital were also involved in the study,including 93 Uighur patients and 122 Han patients.Then the total 712 patients were detectedby using PCR -SNP Stream technology to analyse rs2383206.rs10757278 loci SNP genotyping.The relevant results were compared with t test,two different genotype distribution and allele frequency were compared with χ2 test,multiple factors analysis were calculated by Logisitic regression.Results The distribution of genotype with two SNP loci had no significant difference between the patients in Uygur group and Han group (rs2383206χ2 =5.570,P =0.062;rs10757278 χ2 =2.721,P =0.257 ),and there's no significant difference between the patients with macrovascular disease and non -macrovascular disease in all patients(rs2383206χ2 =0.120,P =0.950;rs10757278 χ2 =1.027,P =0.598).Logisitic regression analysis showed that the incidence of macrovascular was significantly associated with increasing age(χ2 =28.820,P =0.000)and fatty liver(χ2 =5.210,P =0.020)in Uighur group with type 2 DM.In Han group with type 2 DM,the macrovascular was significantly associated with the increase of age (χ2 =19.980,P =0.000),elevated fasting blood glucose (FPG)(χ2 =4.070,P =0.044)and poor controlled with glycosylated hemoglobin (χ2 =4.280,P =0.040). Conclusion This study found that there's no correlation between two single nucleotide polymorphisms (SNPS)loci (rs2383206.rs10757278)on chromosome 9 p21 large with macrovascular in Uygur group and Han group.Increasing age,higher FPG and poor controlled with glycosylated hemoglobin combined with fatty liver were the risk factors for macrovascular.

Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.

Objective To explore the mechanism of Zibu Piyin Recipe (ZBPYR) on spleen yin deficiency diabetes-associated cognitive disorder (DACD). Methods The rats were randomly divided into control group, diabetes mellitus (DM) group, spleen yin deficiency group, spleen yin deficiency DM group and spleen yin deficiency DM+ZBPYR group (treatment group). Type 2 DM models were established by high-fat food feeding and low dose STZ intraperitoneal injection for 4 weeks. Then the classical compound method was used to construct spleen yin deficiency rat models by improper diet, over exertion and yin fluids exhaustion. The treatment group was given ZBPYR by gavage for 15 days, and the other groups were given the same amount of normal saline. Then cerebral cortex, hippocampus, stomach and liver were obtained and the changes of protein expression of PDHE1α in them were observed by Western Blot. Results The protein expression of PDHE1αin cortex of DM group and spleen yin deficiency DM group were lower than control group (P<0.05). PDHE1α expression of treatment group in cortex and stomach increased more significantly than spleen yin deficiency DM group (P<0.05). The expression of PDHE1α protein showed no significant difference among all groups in hippocampus and liver. Conclusion ZBPYR improved spleen yin deficiency DACD by regulating PDHE1αin cortex and stomach.