Objective To discuss the necessity of antibiotics usage in septoplasty , and to provide evidences for the standardization of the therapy and rational use of antibiotics in septoplasty. Methods Eighty-seven patients who had undergone septoplasty were randomly divided into three groups: Group A: without antibiotics; Group B: antibiotics only preoperative prophylaxis; Group C: antibiotics both preoperative and postoperative for five days. The clinical effect and complication rate were compared among three groups. Results There were no statistical significance among three groups for clinical effect and complication rate (P > 0.05). Conclusions The infection rate in septoplasty is very low , and the use of prophylactic antibiotics in elective septoplasty can neither improve efficacy nor reduce postoperative complications , so it is not essential.

Objective To investigate toil-like receptor 4 (TLR4) expression and activity in peripheral blood mononuclear cells(PBMCs) of obese patients.Methods PBMCs from 16 obese patients and 16 normal control subjects were collected.TLR4 and IκBα protein concentrations were measured in PBMCs by western blotting.TLR4 and interleukin-6 (IL-6) mRNA expression levels in PBMCs were measured by quantitative realtime PCR.The blood levels of glucose,insulin,free fatty acids (FFA),IL-6 and tmnor necrosis factor-α (TNF-α) were measured after an overnight fast.Results The levels of FFA,IL-6,TNF-α and homeostasis model assessment of insulin resistance index (HOMA-IR) in obese patients were higher than that of control group (FFA:(879 ± 64) μmol/L vs.(458 ± 48) μmol/L; IL-6:(2.20 ± 0.35) ng/L vs.(1.26 ± 0.25) ng/L; TNF-α:(1.96±0.32) ng/Lvs.(1.38 ±0.24) ng/L;HOMA-IR:(1.8±0.2) vs.(0.4±0.1) ;t=24.613,P=0.000;t =14.993,P =0.000;t =9.128,P =0.000;t =32.254,P =0.000).Increased TLR4 gene and protein expression were observed in PBMCs of obese patients compared with control group(TLR4 mRNA:(3.13±0.21) vs.(0.99 ± 0.03),t =54.758,P ＜ 0.05; TLR4 protein:(7.04 ± 0.42) vs.(2.53 ± 0.17),t =77.450,P ＜0.05).IκBα protein concentration in PBMCs of obese patients (2.52 ±0.16) was lower than in control group (4.00 ± 0.30,t =23.284,P ＜ 0.05),indicating elevated IKKβ/NF-κB signaling.The increase in TLR4 and NF-κB signaling was accompanied by elevated expression of the NFκB-regulated gene IL-6 ((2.55 ±0.15) vs.(1.03 ±0.11),t =53.981,P ＜0.05).Conclusion TLR4 expression and activity are increased in the PBMCs of patients with obesity and might involve in the development and progress of insulin resistance.

Objective To investigate the personality traits, anxiety and depression in patients with leukemia. Methods A cross-sectional survey was performed in 120 patients with leukemia and 118 age and gender-matched controls. Personality was assessed using the Type A Behavior Pattern Questionnaire (TABPQ). Emotion was ascertained using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The relationship between personality type A and anxiety and depression was evaluated by Pearson correlation analysis. Results The prevalence of personality type A was significantly higher in patients with leukemia than healthy controls [71.67 % (86/120) vs. 30.51 % (36/118), P< 0.01]. Patients with leukemia also had higher prevalence of anxiety and depression compared with healthy controls [36.67%(44/120) vs. 9.32%(11/118), P< 0.01; 29.17 % (35/120) vs. 5.93 % (7/118), P< 0.01]. Pearson correlation analysis showed that time-hurry (TH) and competition-hostility (CH) of personality type A correlated positively with anxiety (r=0.292, r= 0.277, respectively; both P< 0.05). Conclusion TH and CH of personality type A are associated with anxiety in leukemia patients.

Objective To study the spinal neurocyte apoptosis and the changes of p53 in chronic fluorosis rats,and the improvement after drinking no fluoride water.Methods One hundred twenty Wistar rats were divided into 4 groups by random number table method according to body mass,30 rats in one group fed with high concentration NaF water (200 mg/L) to make fluorosis model and classified as high fluoride group;other 30 rats were fed with distilled water as control group;another 30 rats were fed with high concentration NaF water (200 mg/L) for 12 weeks,then fed with distilled water for 12 weeks and classified as defluorination group;the rest 30 rats were classified as defluorination control group.The content of fluoride in urine was tested after the 4th,8th,and 12th weeks.Then the content of fluoride in urine of defluorination group and defluorination control group was tested.The high fluoride group rats and control group rats were killed after 12th week.Defluorination group rats and defluorination control group rats were killed after 24th week.Their spinal cord was collected.The expression of p53 protein in spinal cord was detected by immunohistochemistry and Westem blotting.Apoptosis of the neurocyte was quantitatively analyzed by flow cytometry (FCM).Results By FCM,apoptosis of neurocyte was increased in both high fluorosis group rats and defluorination group rats compared with those in control group rats [(3.36 ± 0.71)％ vs.(0.78 ± 0.65)％;(3.47 ± 0.56)％ vs.(0.83 ± 0.64)％,t =14.680,17.003,all P ＜ 0.01)],but no difference was found between these two groups [(3.47 ± 0.56)％ vs.(3.36 ± 0.71)％,P ＞ 0.05)].Immunohistochemistry and Western blotting revealed that p53 expression in spinal cord of high fluorosis group rats was increased compared with those in control group rats (422.69 ± 12.35 vs.177.82 ± 14.16;253.37 ± 10.42 vs.87.14 ± 7.39,t =77.212,72.988,all P ＜ 0.01).And p53 expression in spinal cord of defluorination group rats was increased compared with those in control group rats (418.75 ± 11.84 vs.163.47 ± 8.57;248.29 ± 10.23 vs.98.74 ± 11.52,t =95.663,53.167,all P＜ 0.01).But the differences were not statistically significant (418.75 ± 11.84 vs.422.69 ± 12.35;248.29 ± 10.23 vs.253.37 ± 10.42,t =1.261,1.906,all P ＞ 0.05).Conclusions There is apoptosis of neurocytes in the spinal cord of chronic fluorosis rats;overexpression of p53 probably plays an important role in the mechanism of damage induced by excessive fluorine.Apoptosis can not be recovered after defluorination for a short time,and persistent overexpression of p53 may be one of the reasons that apoptosis of neurocytes in the spinal cord can not decrease.

Objective To investigate thyroid hormone nuclear receptor expression in peripheral blood mononuclear cells (PBMCs) and its relation with injury severity in patients with severe multiple trauma.Methods Twenty-eight patients with severe muhiple trauma and another 26 healthy subjects as control were enrolled in the study.At 2 days after injury,the levels of free triiodothyronine (FT3),free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in peripheral venous blood were determined by using immunoradiometry,and the expressions of mRNA of the thyroid nuclear receptors (TRα and TRβ) in PBMCs were measured by using real-time RT-PCR.Results FT3 concentration in peripheral venous blood was significantly decreased in patients with severe multiple trauma versus healthy subjects.Concurrently,the expressions of TR mRNA (TRα and TRβ) were significantly decreased in PBMCs of patients with severe multiple trauma compared with healthy subjects (TRα mRNA:3.86 ±0.54 vs.5.24 ± 1.17,P ＜0.05;TRβ mRNA:9.86±2.27 vs.13.57 ±2.45,P ＜0.05).Pearson correlation analysis showed that FT3 concentration and the expression of TRβ mRNA correlated negatively with injury severity score (ISS) in patients with severe multiple trauma (r=-0.445,-0.496,P=0.018,0.007).Conclusions These data provide the evidence of a lowered activity of the thyroid signaling pathway in PBMC and a significantly negative correlation between FT3 concentration and the expression of TRβ mRNA in respect of injury severity in patients with severe multiple trauma.Additional investigations are needed to further determine the roles of the thyroid signaling pathway in adverse outcomes in the wake of severe multiple trauma.

Objective To explore the value of SOD activity in diagnosis of central nervous system leukemia (CNSL )by detec-ting SOD activity of cerebrospinal fluid of patients with CNSL .Methods The cerebrospinal fluid of 55 patients from department of hematology of Nanfang hospital of southern medical university were collected from January 2008 to January 2009 ,in which 30 pa-tients suffered with central nervous system leukemia (CNSL group) ,the other 25 patients suffered with acute leucemia without im-paired central nervous system(control group) .The SOD activity of cerebrospinal fluid was detected by the xanthine oxidase meth-od ,while the routine test ,biochemistry test and cell smear of cerebrospinal fluid was detected .Results There were statistics differ-ence in the level of white cell and protein in cerebrospinal fluid between CNSL and control group (P<0 .05) ,but with no difference in the level of cerebrospinal fluid pressure ,glucose ,chlorine(P>0 .05) .There was statistics difference in the level of SOD activity between CNSL and control group(P<0 .05) .The white cell quantity and the protein level in cerebrospinal fluid had negative corre-lation with the activity of SOD ,(r=0 .871 ,P=0 .000 ;r=0 .518 ,P=0 .003) .The activity of SOD in the cerebrospinal fluid had sta-tistics difference before and after intrathecal chemotherapy (P<0 .05) .The activity of SOD in the cerebrospinal fluid whose under 45 year-old (755 .64 ± 345 .77) ,which was significant lower than that of the paitents whose equal with or above 45 year-old (1 420 .49 ± 307 .69)(P<0 .05) .Conclusion The changes of the SOD activity in the cerebrospinal fluid had relation with central nervous system leukemia ,and the SOD activity might be a auxiliary diagnosis index used in central nervous system leukemia by revi-sing age factor .

BACKGROUND:Some scholars have found that cervical vertebral body bone trabecula was reduced,became thin,even perforated in old patients with osteoporosis.Whether this change will induce cervical vertebral body deformation,and what relationship to the onset of cervical syndromeOBJECTIVE:To study the relation of cervical spondylotic myelopathy and osteoporosis by measuring and comparing.METHODS:A totaI of 40 subjects with normal lumbar vertebra density and without cervical spondylosis were enrolled as control group,averagely 32 5 years.A total of 30 patients with cervical spondylosis served as cervical spondylosis group,averagely 43.6 years.Totally 46 patients with cervical spondylosis and osteoporosis served as combined with osteoporosis group,averagely 58.6 years.116 subjects underwent radiograph Height and sagittal diameter of the vertebral body ratio of height to sagittal diameter of the vertebral body.and ratio of sagittal diameter of cervical canal/vertebra body were measured.RESULTS AND CONCLUSION:Compared with the control group.vertebral height was decreased.and sagittal diameter became longer(P＜0.05),and the ratio of sagittal diameter of cervical canal/vertebra body became smaller(P＜0.05)in the combined with osteoporosis group.Vertebral body deformation was characterized by decreased vertebral height and prolonged sagittal diameter became flat.Results suggested that osteoporosis induced cervical vertebral deformation,correlation between osteoporosis and cervical spondylosis,which may be a factor for cervical spondylosis development.

Objective To explore the clinical efficacy in bilateral lumbar foraminal stenosis (LFS) after treatment with bilateral facetectomy combined with pedicle screw fixation and interbody fusion.Methods A total of 41 cases of patients with bilateral LFS underwent bilateral facetectomy combined with pedicle screw fixation and interbody fusion from February 2010 to August 2013 in Department of Spine Surgery,the People's Hospital of Tianjin City,were retrospectively analysed.The clinical efficacy was assessed by Oswestry disability index (ODD questionnaire and visual analogue scale (VAS) before and after operation,anterior and posterior disc height and L1-S1 angle were measured as well.Then the ODI and VAS scores,and changes in anterior and posterior disc height and L1-S1 angle were calculated at the time of the last patient follow-up visit.Results All 41 patients were followed up for 12 to 36 months,with an average of (26.2±2.4) months.Compared with preoperation,at the time of the last follow-up visit the back pain VAS score,leg pain VAS score and ODI were decreased,while the anterior and posterior disc height were increased,there were statistically significant differences (P＜0.05).No statistically significant difference was found in L1-S1 angle between preoperation and postoperation (P＞0.05).Conclusion The short-term clinical curative effect of posterior bilateral facetectomy combined with pedicle screw fixation and interbody fusion in the treatment of bilateral LFS is satisfactory.

Objective To test the RET-proto-oncogene in a multiple endocrine neoplasia type 2( MEN2) family for confirming the diagnosis and classification , guiding treatment and prevention , and improving the prog-nosis.Methods There were 2 patients of MEN2 with clinical diagnosis and 1 asymptomatic first-degree relative in the pedigree .PCR and direct gene sequencing of PCR produces were used to scan the entire 21 exons of RET-proto-oncogene in the 3 members of the pedigree and 3 normal controls .Results The 2 patients and 1 asympto-matic first-degree relative in the pedigree all had a mutation of the codon 634 in exon 11.It was a heterozygous missense mutation C634R(TGC → CGC).The 3 normal controls showed no abnormalities .Conclusion The gene test of RET proto-oncogene helps to confirm the diagnosis of the pedigree as MEN 2, which can guide the treatment and help identify one asymptomatic mutation carrier .

Objective To study the association of transcription factor 7-like 2(TCF7L2)polymorphisms with tvpe 2 diabetes mellitus in Chinese Han population. Methods Two polymorphisms (rs7903146 and rs12255372)of TCF7L2 gene were genotyped in 446 patients with type 2 diabetes mellitus(T2DM group)and 303 normal subiects (NC group) by PCR-restriction fragment length polymorphism(PCR-RFLP).Waist circumference.body mass index,plasma glucose,serum insulin,lipid profiles,high-sensitivity C-reactive protein and non-esterified fatty acid were measured.Homeostasis model assessment of insulin resistance(HOMA-IR)and β-cell function(HOMA-β)were calculated.Results (1) In T2DM group,T allele frequency and CT,TY geno tvpe frequeneies of rs7903146 were significantly higher than those in NC group(0.093,0.150,0.018 vs 0.043, 0.079,0.003,respectively,a11 P