Objective:To evaluate the efficacy of the resection of nasal inverted papilloma (NIP) under endoscope.Methods: A total of 100 patients with NIP from April 2008 to December 2013 in our hospital were randomly divided into endoscopic surgery group (endoscopic group) and conventional surgery group (conventional group), each with 50 cases. All patients were followed up for 2 years, whose recurrence, complications and satisfaction were observed. Results: The patients were followed up for 2 years, and the recurrence rate between the two groups was not statistically significant (x2=0.96,P>0.05). The traditional group had a higher incidence of complications than the endoscopic group, and the difference was statistically significant (x2=4.16,P<0.05). Endoscopic patients’ satisfaction was higher, and the difference was statistically significant (x2=5.02,P<0.05).Conclusion: The resection of (NIP) under endoscope can reduce the incidence of complication, improve patient satisfaction, and will not increase the recurrence rate, which is an effective means of treatment to the NIP.

Objective To improve the knowledge of CT appearances of spondylolysis of the lumbar spine.Methods 32 patients with lumbar spinal spondylalysis were examed by Elscint 2400 CT.CT appearances were analyzed.Results The CT feature of spondylolysis was loop-broken sign.Spondylolisthesis was present in 25 cases,the CT mainfestations included the increased anterior pasterior diameter of spinal canal,wich sign,deformity of vertebral canal and pseudobulging disk.Other features included asymmetrical zygapophysial joints.Conclusion “loop-broken sign” is a relatively specific CT appearance of spondylolysis of the lumbar spine,which is significant in diagnosting spondylolysis without spondylolisthesis.

Objective Acute liver failure is one of the significant causes of death clinically.It is important to explore new serum markers of liver injury for early diagnosis and prognosis prediction of severe liver disease.Hepassocin ( HPS) is a liver-specific mitogenic growth factor.Our study is intended to investigate the correlation between HPS serum levels and the degree of liver injury.Methods Firstly, a mouse model of acute liver injury was constructed via intraperitoneally injection with different doses of CCl4 .Then the survival rate, alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) and the pathological changes in the liver were detected.Meanwhile, ELISA assay was performed to detect the serum level of HPS.In addition, the mRNA level and protein level of HPS were detected by real-time PCR and Western blotting, respectively.Results The mortality rate was increased and the liver damage was aggravated with the increase of the CCl4 dose.Besides, the ALT and AST levels were also increased in a dose-dependent manner.Additionally, the mRNA and protein levels of HPS were significantly up-regulated and closely related to the degree of the liver injury in the model. Conclusion HPS can be used as a new marker of liver injury in mice.

Objective In order to understand the depression situation of the hospitalized tuberculosis patients.Methods Zung depression was used as a tool for assessment,the objective of 130 patients hospitalized for tuberculosis survey.Results 58.5% of the hospitalized tuberculosis patients showed symptoms of depression,compared with the secondary and 3 care patients,the rate was high among the level care patients,meaningful differences(P

Objective To establish an effective method for determination of synthetic cannabinoid JWH-122 by the high-performance liquid chromatography (HPLC), which is controled by China’s Regulations on non-clinical narcotic and psychoactive drug. Methods Methanol-deionized water (50%-50%) was used as mobile phase for gradient elution. In addition to the initial concentration in organic phase, gradient steepness, column temperature, flow rate and other chromatographic conditions, the determine wavelengths were tested so as to ifnd out optimal experimental conditions. Linearity range and speciifcity were tested under optimal conditions, and actual samples were used to verify the method established. Results Under the condition of ultraviolet spectrum detection wavelength at 221nm, initial concentration of 70%, organic phase gradient steepness of 0.5%/min, lfow rate at 1.2 ml/min and column temperature of 30℃,excellent linearity of JWH-122 was observed at 0.002mg/mL-0.1mg/mL and the detection limit (S/N≥3) was 0.1μg/mL. The test of actual samples suggested that JWH-122 was able to be well separated from the sample under the optimal conditions. Conclusion Our method has advantages of rapidity, sensitivity, accuracy and excellent separation efifciency, and is capable of the detection of synthetic cannabinoid JWH-122 of the novel “spice” drugs.

Objective To investigate the expression of endocytic receptor megalin and cubilinin in the developing mouse kidneys, and the correlation between the expression and the development of the renal tubules. Methods Expression of megalin and cubilin in developing mouse kidneys was examined at different embryonic days (E) using immunohistochemistry. Meanwhile, the ultrastructure of developing proximal tubules related to endocytosis was observed at transimission electron microscope level. Results At E9.5, megalin and cubilin were co-expressed in apical plasma membrane of the mesonephric ducts and mesonephric tubules. From E11 to E18, in the metanephros, the expression of both receptors were seen at the free surface and apical plasma of uretic bud, but weakly in all renal tubules of S shaped body at early differentiatial stage. With the mature of proximal tubule development, they were both confined to the brush border and the apical plasma of the proximal tubules in juxtamedullary cortex.Conclusion The endocytic receptors, megalin and cubilin are expressed in apical part of nearly all renal tubule epithelia in early development, and confined to free surface of mature proximal tubules, suggesting that with the mature of proximal tubules, the two receptors are generally involved in collaborating to facilitate, the reabsorption of ultrafiltration.

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

Objective To observe on the clinical effect and the influence of the level of plasma vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (VEGFR) and basic fibroblast growth factor (bFGF) in acute leukemia before and after treatment by thalidomide combined with chemotherapy. Methods Thirty-six cases of acute leukemia patients were randomly divided into experimental group and control group by 18 cases each. Each group was treated with conventional chemotherapy in the standard-dose, meanwhile in the experimental group additional thalidomide 100 mg/day were taken orally. Before treatment and 8 weeks after treatment, plasma were collected for the detection of VEGF, VEGFR and bFGF content by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).Results The ratio of experimental group and control group, were 88.9 % (16/18), 77.8 % (14/18)respectively and the difference was statistically significant (x2 =4.103, P ＜0.05). The level of plasma VEGF (389.78+249.94 pg/ml, 318.54±125.78 pg/ml) of experimental group and control group before treatment was statistically significant (t = 3.141, t =3.024, P ＜0.01) compared with healthy group [(132.91±26.66) pg/ml] respectively. The level of plasma VEGF of those groups after treatment [(211.74+36.72) pg/ml, (288.02±31.77) pg/ml] was statistically significant (t =2.413, t =2.324, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma VEGF of experimental group and control group before treatment was not statistically significant (t =1.384, P ＞0.05). The difference of the level of plasma VEGF of experimental group and control group after treatment was statistically significant(t =2.793,P ＜0.05). The level of plasma VEGFR [(2490.75+1695.9) pg/ml, (2322.78+1105.87) pg/ml] of experimental group and control group before treatment was statistically significant (t =2.914, t =2.783, P ＜0.01) compared with healthy group [(1134.98+378.45) pg/ml] respectively. The level of plasma VEGFR of those groups after treatment [(1359.71± 390.24) pg/ml, (1753.89±337.04) pg/ml] was statistically significant(t =2.572, t =2.447, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma VEGFR of experimental group and control group before treatment was not statistically significant (t =1.276, P ＞0.05). The difference of the level of plasma VEGFR of experimental group and control group after treatment was statistically significant (t = 2.486, P ＜0.05). The level of plasma bFGF [(2.43±0.27) ng/ml, (2.41±0.33) ng/ml] of experimental group and control group before treatment was statistically significant(t =4.982, t =4.171, P ＜0.05) compared with healthy group (1.83±0.44) ng/ml respectively; the level of plasma bFGF of those groups after treatment [(2.09±0.17) ng/ml,(2.11±0.31) ng/ml] was statistically significant (t =3.011, t =2.773, P ＜0.05) compared with healthy group respectively. The difference of the level of plasma bFGF of experimental group and control group before treatment was not statistically significant (t =0.953, P ＞0.05). The difference of the level of plasma bFGF of experimental group and control group after treatment was not statistically significant (t =1.282, P ＞0.05).Conclusion The remission rate could be improved by thalidomide combined with chemotherapy in acute leukemia, which could be an effective treatment by anti-angiogenesis and inhibiting the growth and infiltration of acute leukemia cells.

lymphocytic thyroiditis.

Background and purpose: L-asparaginase (L-Asp) is an important drug in the treatment of childhood lymphoid neoplasms at present, but a lot of adverse reactions of L-Asp were observed. Pegasparaginase (PEG-Asp) is available in China in recent years. This study aimed to explore efifcacy and side-effect of PEG-Asp as ifrst-line treatment in childhood acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL). Methods:A total number of 211 ALL or LBL patients were treated with CCLG 2008 or BFM-90 protocol with PEG-Asp or L-Asp between Apr. 2008 and Mar. 2013;42 patients, among whom, were 35 ALL patients and 7 LBL patients, were treated with PEG-Asp as ifrst-line treatment;169 patients were treated with L-Asp as ifrst-line treatment (including 53 patients treated with L-Asp during induction protocol; with PEG-Asp during consolidate protocol). The clinical outcome and adverse reaction of PEG-Asp with L-Asp were observe and compared. Results: There were 35 ALL patients in PEG-Asp ifrst-line treatment group and the complete remission rate after 1 course of PEG-Asp was 97.1%,however, which was 83.3%of high risk ALL patients. The complete remission rate of 7 LBL patients of PEG-Asp ifrst-line treatment group was 57.1%. There was no signiifcant difference between 2 groups (P>0.05). Thirty-four patients relapsed including 5 patients of PEG-Asp ifrst-line treatment group, 16 patients of L-Asp ifrst-line treatment group and 13 patients treated with L-Asp during induction protocol and with PEG-Asp during consolidate protocol. Thirty-one patients died including 3, 18, 10 patients in 3 groups respectively. Twenty-two patients died of relapse, 4 died without remission, 5 died of complications. There was also no signiifcant difference between 2 groups (P>0.05). The incidence rates of adverse reactions were 47.6% and 63.3% respectively. Anaphylaxis, liver functions abnormalities, blood coagulation abnormalities, gastrointestinal reaction, hyperglycemia and pancreatitis were common in our patients. The incidence rate of anaphylaxis in PEG-Asp as ifrst-line treatment group was lower than other groups (P=0.03). But there was no signiifcant difference been observed in the incidence of other adverse reaction. Conclusion: The short-term efifcacy of PEG-Asp as the ifrst-line treatment in childhood leukemia and lymphoma was satisfactory and the incidence rate of anaphylaxis was lower. However, we will still pay much attention to adverse reaction monitoring of PEG-Asp.