Objective: To study the mechanisms and treatment of ischemia/reperfusion injury. Expression of E selectin was measured and the effect on suppression of E selectin by the Pyrrolidine Dithiocarbamate was investigated. Methods: Endothelial cells were exposed to hypoxia, then returned to reoxygenation condition. ELISA methods were used to detect expression of E selectin. Results: E selectin expression on hypoxia/reoxygenation stimulated endothelial cells increased, PDTC could suppress translation of E selectin effectively. Conclusion: It seems that E selectin may act as a critical factor. PDTC may prove beneficial in the treatment of ischemia/reperfusion injury.

OBJECTIVETo investigate the therapeutic effect of alar rotation flap for severe alar retraction.

METHODSPatients with severely retracted alar underwent ala reconstruction using alar rotation flaps and autogenous cartilage batten grafts. First, costal cartilage was used to reshape the nasal tip and nasal dorsum. Then cartilage patch was used to extend and thicken the retracted alar. Then the alar rotation flap was transferred to correct retracted alar.

RESULTSFourteen patients with severe alar retraction underwent alar reconstruction with alar rotation flap and alar batten grafts. The alar retraction was corrected in all cases, with improvements functionally and aesthetically. No recurrence of alar retraction was noted. The incision healed with acceptable cosmetic results, with obvious scar in only one patient (one side).

CONCLUSIONSThe alar rotation flap is an effective and reliable surgical option to correct severe alar retraction. Scar can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum, following principles of the aesthetic nasal subunits.

Cartilage ; transplantation ; Cicatrix ; prevention & control ; Costal Cartilage ; transplantation ; Esthetics ; Humans ; Nose Deformities, Acquired ; surgery ; Rhinoplasty ; methods ; Rotation ; Surgical Flaps

Thyroid carcinoma is the most common malignant tumor in the endocrine diseases,with a rising morbidity.As more investigations were made,thyroid stimulating hormone receptor is showed up,and it is believed some contacts are existed between thyroid stimulating hormone receptor and thyroid carcinoma.We believe that making sure of these contacts can help patients in diagnosis,treatment,and prognosis.

Objective To investigate the changes of panel reaction antibody (PRA) and the effects of HLA sensitized paths in patients waiting for renal transplantation.Methods PRA of 10 555 samples from 8926 renal transplant recipients in 51 transplant centers was analyzed.In 1991-1998 group,PRA was by using NIH-CDC technique,and in 1999-2010 group,PRA was detected by using ELISA.The effects of blood transfusion,pregnancy and transplantation on the PRA positive rate were analyzed.Results There were 1324 recipients positive for PRA in 8926 (14.83 ％ ).The average PRA positive rate in 1991 1998 group and 1999-2010 group was 18.17％ (513/2823) and 13.29％ (811/6103) repectively (P＜0.01).Among 1324 PRA positive recipients,the number of recipients with PRA of 1％-30％ and PRA of ≥30％ respectively accounted for 71.83％ and 28.17％.There were statistically significant differences in the PRA positive rate between the recipients receiving blood transfusion and those without blood transfusion (31.77％ vs 1.21％,P ＜ 0.01 ),between the recipients having pregnancy history and those without pregnancy history (24.64％ vs 7.19％,P＜ 0.01 ),and between primary transplant and re-transplant recipients (13.35 ％ vs 40.62％,P＜0.01).Conclusion In last 20 years, PRA in majority of PRA positive recipients was ＜ 30％ (low sensitized).Renal transplantation and blood transfusion were the important influencing factors that led to positive PRA,and pregnancy history was a related factor.

Objective To present the authors' initial experience of treating auricular arteriovenous malformations (AVMs) with ethanol embolization and to assess the clinical effectiveness of this therapeutic method. Methods Twenty-two patients with AVMs were enrolled in this study. Through local puncturing or super-selective catheterization the absolute ethanol, or diluted alcohol (based on the pattern of the AVMs), was manually injected into the abnormal vascular plexus of the auricular lesion. The clinical results were estimated with physical examination or angiography at intervals of 3 ～ 4 month, and telephone questionnaire was made at monthly intervals for all patients. Results Thirty-eight ethanol embolization procedures were performed, the amount of ethanol used during the procedure ranged from 4 ml to 65 ml. After the treatment the clinical symptoms were improved, which were manifested as healing of the ulceration, stop of bleeding, disappearing or alleviation of tinnitus. Angiographic examination showed that the abnormal vascular lesion was completely vanished in 9 cases, decreased by 50% -75% in 8 cases and decreased less than 50% in remaining 5 cases. The common complications included irreversible local necrosis and vesiculation. Conclusion For the treatment of auricular AVMs ethanol embolization is an effective and safe method, which might become the therapy of first choice.

Objective To explore the clinical manifestations, diagnosis, treatment and prognosis of secondary thyroid neoplasms. Methods To retrospectively analyse clinical manifestations,examinations and treatment of 83 cases of secondary thyroid cancer, which were retrieved from CNKI (1994-2008). Results In all cases, 39 were male, 39 were female and 5 were unknow, aged from 16 to 78 years old, median age was 52. The primary cancers included 31 esophageal carcinomas, 12 lung cancers, 8 laryngopharynx cancers, 7 clear cell renal carcinomas, 6 rectal carcinomas, 6 melanomas, 3 breast cancers, 3 rhabdomyosarcoma, 2 gatric cancers, 1 liver cancer, 1 cervical cancer, 1 nonchromaffin paraganglioma,1 ovary cancer, 1 lip squamous cell carcinomac. 64 patients had undergone chemotherapy or surgery or radiotherapy. The intervals between finding of primary carcinoma and secondary thyroid carcinoma ranged from 1 month to 26 years with a median time of 2.5 years. Patients died of widespread metastases from 1 month to 12 years following the diagnosis of secondary carcinoma in thyroid, with a median time of 32 months. Conclusions Metastasis in the thyroid gland is uncommon and may cause a diagnostic problem. Metastatic cancer to the thyroid should be considered when a patient with histoy of malignant tumor has a recent found thyroid lesions. With the combination of Surgery, chemotherapy and radiotherapy, the survival of patients can be significantly prolonged.

OBJECTIVE:To provide reference for further development of Internet drug transaction services in China. METH-ODS:The data of online drugstores with top 20 approvals data and sales amount were collected bu the Internet,the normative man-agement was evaluated. Meanwhile,questionnaire was conducted to survey and analyze the cognition,buying drugs and correspond-ing requirements of some Shanghai citizens for Internet drug retail. RESULTS:By Jun. 12,2015,totally 307 retail chain drug-stores(online drugstores)had got the License of Internet Drugs Transaction,only 62 online drugstores(20.2%)were in full compli-ance with the normative management;the top 19 online drugstores supplied averagely 1 072±815 OTC medicines,including 259± 165 chemical drugs and 813 ± 650 Chinese traditional medicines,and the top 3 were jianke.com (3 658 species),J1.com (2 071 species)and 360 kad.com(1 523 species). Totally 216 questionnaires were sent out,and 183 were effectively received with effec-tive recovery of 84.7%. The 183 surveyed citizens showed high cognition in distinguishing the authenticity of online drugstores (75.4%) and the authenticity of drugs (67.1%),but low cognition in online drugstore opening qualifications and Internet selling drugs;only 22.4% had the experience of buying drugs online,the degree of satisfaction towards online shopping,from the highest to the lowest,were drug price(62.5%),professional consultation of pharmacists(50.0%),variety of drugs(45.0%),quality of drugs(37.5%),delivery time(35.0%),etc.;the most probably purchased medicine category were vitamins and minerals(63.9%) and medicines for common diseases(40.4%). CONCLUSIONS:Currently the demands and confidence of online drugs shopping of Shanghai citizens are still scarce. Though the access of retailing prescription drugs would spur the Internet drug business,the condi-tion is still immature. It is suggested to sell prescription drugs in a limited way and improve their access threshold,promote Medi-care settlement to multi-faceted promote the orderly development of Internet drug transaction services.

Objective To study diagnosis significance of neutrophil surface adhesion molecules including CD11b,in type 2 diabetes mellitus patients with cytomegalovirus (CMV)infection.Methods Blood samples from 139 cases of type 2 diabetes mellitus patients were collected including 99 male and 40 female cases between Septem-ber 2011 and January 2015.Healthy male 20 cases and female 13 cases were collected as healthy control group from outpatients in the same period.Type 2 diabetes mellitus patients were divided into high active CMV infection group, CMV infection group and the negative control group,and healthy group as normal control group according to CMV -pp65 antigen detection.Neutrophil surface adhesion molecule CD11b was analyzed by flow cytometry and compared respectively.ROC curve of CD11b in 2 diabetes mellitus patients was made.Results The expression ratio of CD11b in high active CMV infection group and CMV infection group in type 2 diabetes mellitus patients was (41.25 ± 5.33)%.There was significant difference (P =0.019)compared with negative control group (61.13 ±5.28)% and there was significant difference (P =0.009)compared with negative control group (64.21 ±6.02)%;optimal cut -off value of CD11b in high active CMV infection group was 45.65%,the sensitivity was 100.00%,the specificity in high active CMV infection group was 60.12%,and the area under the receiver -operating curve(ROC)was 0.628;optimal cut -off value of CD11b in CMV infection group was 70.21%,the sensitivity of CD11b was 87.69%,the specificity of CD11b was 99.22%,and the area under of ROC of CD11b was 0.991.Conclusion The neutrophils CD11b expression in type 2 diabetes mellitus patients with CMV infection is down regulation.CD11b expression can be used as a laboratory diagnosis basis of CMV infection.

Objective Onto investigate the indoor quality control method for qualitatively detecting the laboratory indicators of TORCH infection (rubella virus IgG ,cytomegalovirus IgG and IgM ,toxoplasma IgG and IgM ) .Methods The statistical method , normal distribution data ,ratio and standard deviation of positive rate detected by the ELISA method were adopted ,1+2s was set as the out of control rules ,the semi Lerey‐Jennings quality control chart was drawn;the direct probability calculation method was a‐dopted for the non‐normal distribution data and small probability event .The testing data of 57 batches were retrospectively ana‐lyzed .Results The positive rate of rubella virus IgG was 86 .66% ,cytomegalovirus IgG/IgM positive rates were 98 .87% and 0 .13% ,toxoplasma gondii IgG/IgM positive rates were 2 .43% and 1 .71% ,the data of 151 ,3 ,5 ,176 ,27 samples had the critical value range of five indicators .The number of out of control was once for cytomegalovirus IgG ,once and 4 times for Toxoplasma gondii IgG/IgM .Conclusion The indoor quality control for the ELISA qualitative detection of TORCH infection can adopt the data of daily detection positive rate or negative rate for monitoring the false positive .The critical value range of specimens should be fur‐ther conducted the recheck or confirmation experiment .

Objective To explore the application of the virtual private network(VPN) to picture archiving and communication system(PACS) for the remote access and management of PACS.Methods The client-ports(namely the remote computers) were connected to Internet by broadband such as ADSL,and the web server of PACS was connected to Internet by broadband router with VPN function so that the remote computers could access the web server of PACS remotely.By the VPN technology,the system administrators of PACS could diagnose and maintain the general malfunctions of the radiology's local network,and thus the remote management came true.Results The remote access and management of PACS had been available in our hospital for half a year since the application of the VPN technology in PACS.By more convenient medical services the work efficiency had been greatly improved.Conclusion The application of VPN technology to PACS,which is characterized by low expense,dependable performance,simple maintenance,can realize remote access and management of PACS.