Locally advanced nasopharyngeal carcinoma ( NPC) invaded with paranasal sinus as death is associated with disease and independent prognostic factors for local recurrence .Its symptoms are various and atyp-ical,and often causes misdiagnosis or missed diagnosis .Local recurrence and distant metastasis are the main cause of treatment fails .Currently , there are few literature about NPC intruding paranasal sinus .Its occurrence rate,clinical manifestation,imageological change,intruding pathways,diagnosis,treatment and prognosis are sum-marized in this paper .

OBJECTIVE:To provide suggestions and countermeasures for improving the accessibility of national essential medi-cines. METHODS:Based on the theoretical analysis,the questionnaire was designed for the pre-survey and formal survey on the experts from universities,enterprises,government agencies and non-governmental organizations,and analytic hierarchy process was used to analyze and discuss the valid questionnaire. RESULTS:Totally 35 question naires were sent out and 27 were effective-ly received with effective rate of 77.14%. The physicians and pharmacists’cognition of essential medicine system and essential medicine,and the reasonable degree of public bid prices of essential medicine,the fairness and impartiality of essential medicine bidding process were the key influential factors;the prescription,provision,reimbursement of essential medicine,and the financial compensation to primary public health care institutions that sell essential medicine by zero-slip were the secondary factors;primary health care institutions’monitoring on the use of essential medicine(such as prescription rate,etc.),the participation of social se-curity sector in bidding and purchasing of essential medicine,the reasonable degree of pricing of essential medicine,the monitoring of the price of essential medicine,and the compensation to manufacturers of essential medicine were the general factors. CONCLU-SIONS:The accessibility of essential medicine involves many stakeholders,whom impact from different levels. Therefore,all rele-vant stakeholders should be coordinated to gradually improve the accessibility of essential medicines.

OBJECTIVE To understand the susceptibility to antituberculous agents for patients with primary and acquired drug resistance of Mycobacterium tuberculosis. METHODS M. tuberculosis positive sputum samples were collected from Jun to Dec 2006. Ameliorative Lowenstein-Jensen culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis by typing using PNB and TCH. Totally 217 samples were confirmedtobe positive by culturing. Drug susceptibility test against streptomycin (SM),isoniazid (INH),rifampicin (RFP) and ethambutol (EMB) was conducted. RESULTS The total drug resistance rate was 65.90%,the initial drug resistance rate was 39.81% and the initial multi-drug resistance rate was 16.67% ;the acquired drug resistance rate was 91.74%,and the acquired multi-drug resistance rate was 74.31%. The main causes of drug resistance were irregularit of treatment at beginning and preterm stop of the freatment course by patients own selves,which accounted for 71.6%. CONCLUSIONS The drug resistance of M. tuberculosis is caused by irregular treatment,so the key to prevent and control drug resistance is rational and whole-course treatment.

Traumatic asphyxia is a result of sudden or severe compression of the thorax and/or the upper abdomen.A sudden increase of intravascular pressure transmitted to the intra-and extracerebral vessels may cause petechial hemorrhage in the brain and in the skin over the head,face,neck and shoulder regions.Severe cerebral anoxia accompanying the injury may lead to cerebral edema and the appearance of signs of increased intracranial pressure as well as ARDS following hypoxemia.Spinal puncture and EEG are helpful in early diagnosis.The essential therapeutic measures consist of improvement in ventilation,dehydration and the use of glucocorticoid hormones.By such manoeuvres,11 of 12 patients we treated recovered satisfactorily and only 1 of them succumbed.

Objective To investigate the risk factors of incidence of hypertensive disorder complicating pregnancy(HDCP)and provide reference for prevention and treatment of HDCP.Methods The clinical information of 2 217 cases of maternal delivery were retrospectively analyzed;The relevant social factors and obstetric factors of HDCP were analyzed.Results 186 cases of HDCP occurred in 2 217 cases of maternal,the incidence rate of HDCP was 8.4%.The single-factor analysis showed that the place of residence.prenatal system checks and parity had certain degree of contact with incidence of HDCP(χ2=11.2331,10.6781,5.4456,all P＜0.05),and the age,abortion history and parity had no significant correlation with incidence of HDCP(χ2=4.9201,3.0134,1.7301,all P＞0.05).Multivariate Logistic regression analysis showed that the rural living and no prenatal system check were risk factors of incidence of HDCP.Conclusion The maternal of rural living and no prenatal system check were the high-risk population of HDCP,and emphasis assessment and reasonable control these factors could reduce the incidence of HDCP.

Objective To investigate the influence of human menopausal gonadotropin(HMG)administration at different phase of follicular development upon the outcome of in vitro fertilization-embryo transfer(IVF-ET)in the long-program.Methods A retrospective analysis was performed in 145 patients underwent the long program IVF-ET,who were normal in ovarian reservation but with low levels of serum leteinizing hormone(LH)(＜ 1 U/L)after the pituitary down-regulation.According to the time point of HMG administration,the patients were classified into three groups:early follicular phase(group 1,43 patients),midfollicular phase(group 2,46 patients)and late follicular phase(group 3,56 patients).The outcomes of these three groups were compared.Results Between the three groups,there was no difference in the down-regulation time,days receiving gonadotropin(Gn),the number of oocytes retrieved,day of estradiol(E2)on the day receiving chorionic gonadotrophin(hCG)injection,start date and interim LH,fertilization rate and cleavage rate (all P ＞ 0.05).In group 3,the total Gn dosage([2225 ± 292]U)was lower than that of group 1([2624 ± 422]U)(P ＜ 0.05)and group 2([2472 ± 417]U)(P ＜ 0.05).In group 1,the LH level on the day receiving hCG[(0.46 ± 0.37)U/L]was lower than that in group 2[(0.72 ± 0.58)U/L](P＜0.05).The rate of usable embryos in group 3[62.5％(288/461)]was higher than that of group 1[55.0％(170/309)]and group 252.8％(208/394)](P =0.011).Though the high qualified embryo rate,clinical pregnancy rate and implantation rate in group 3 were higher than that in goup 1 and group 2,and the abortion rate in group 1 was higher than that of group 2 and group 3,the difference was not significant(P ＞ 0.05).Conclusion For the patients with over-suppressed LH in the long-program pituitary down-regulation but with normal ovarian reservation,additional HMG during late follicular phase is helpful to improve the high qualified emryo rate,excellent rates of embryos,embryos availability,implantation rate and clinical pregnancy rate,and lower the abortion rate.

Objective:To study the epidemiology of inpatients with fractures and discuss its effect on health education.Methods:Therer were 6290 inpatie nts with fracture investigated retrospectively.FoxPro and SPSS were used for statistical analysis.Results:The mean age of the patients was 41.03±20.05 years.The fraction male to female patients was 2.39:1.The mean hospitalized days were 24.11±22.73 days (±s).A majority(63.5%) of the patients were admitted to the hospital by emerg ency.Fractures in 15 parts accounted for 70% of total fractures in 6 hospital, 7 of which accounted for more than 50% of total fractures in each hospital.Discussion:Health education should be carried out according to risk factors as well as age and gender.The devel opment of the model,which combines prevention,first-aid and rehabilitation,is t he trend of health education for fractures.The basic knowledge of fractures in these 15 parts should be learned by orthopedic nurses.Patient education should be carried out individually.The hospital's situation should also be considered.

Objective To investigate the effect of hysterectomy and uterine arterial embolization on the function of ovary.Methods The serum concentrations of estrin(E2), progestogen(P),fouicule-stimulating hormone(FSH),luteotropic hormone(LH) and prolaction(PRL) were measured in 18 patients undergone hysterectomy (group Ⅰ),15 patients undergone uterine arterial emboliation(group Ⅱ) and 30normal women (group Ⅲ or control group).These five hormones were compared in each group.Results The serum concentrations of E2 and P in the group Ⅰ were lower than that in group Ⅲ, there was significant difference between them.The serum concentrations of E2 and P in group Ⅱ and group Ⅲ was no significant difference.Conclusion Hysterectomy has significant effects on the function of ovary,while uterine arterial embolization has not.

The in vitro modulation effect of insulin on DNA and IL-2 production of spleen lymphocytes in diabetic mice were studied. The results suggest that the DNA and IL-2 production of the lymphoc-ytes are significantly inhibited in the mice. When suspend the lymphocytes to the culture medium containing insulin, the DNA and IL -2 production of the lymphocytes are remarkably increased. Therefore, insulin is an important immunoregulation hormone.

Objective To investigate the relationship of cardiac function and ventricular structure with the training intensity and the periods lived in Tibet.Methods Sixty recruits to Tibet were selected and examined of their cardiac function,cardiac ventricular structure and the changes of elctrophysiology by color Doppler echocardiography and electro cardiogram.They were examined continuously in two years.After their training for three months together,they were divided into the different training intensity groups,Group A and Group B.The 30 recruits in Group A had high-intensity training,and the others in Group B had normal training.Results After three months,their cardiac function and ventricular structure had obvious difference in comparison with the level on plain( P 0.05 ).But there were obvious differences between in Tibet and on plain in the parameters of cardiac function and ventricular structure two years later( P 0.05 ).Conclusions Hypoxia can effect the cardiac function and ventricular structure directly.After three months in Tibet,cardiac function can fit the condition of hypoxia.The parameters of cardiac function are still less than those on plain.The right ventricules are bigger and the pulmonary arteries wider as the main character of the ventricular structure changes.The indexes of cardiac function showed no significant difference with the training intensity and the periods in Tibet.