Objective To study in patients characteristics of head CT and MRI of patients with brain stem injury at acute stage(＜7 days)and discuss the relationship of head MRI manifestations and prognosis so as to provide indicators for imaging diagnosis and prognostic evaluation.Methods The patients with brain stem injury from November 2007 to September 2008 were involved in the study.Cranial CT and MRI were performed at early stage after brain stem injury.The patients were followed up for six months to evaluate prognosis and life quality of the patients based on disable rating scale(DRS)and Barthal score.Results MRI could detect more brain stem injuries than CT.The patients with injury at different parts of brain stem showed a statistical difference in regard of prognosis.Conclusions At acute stage of brain stem injury,cranial MRI has higher detection rate and clearer display of the brain stem lesions compared with CT.MRI manifestations can not only help classification of the brain stem injury,but also cater basis for diagnosis and prognosis evaluation of patients with brain stem injury.

As a minimally invasive method of examination, magnetic resonance spectroscopy can provide information of brain metabolism and biochemistry, objectively reflect brain metabolite changes. Different manifestations were described in the diseases such as brain injury and brain tumor. As a result, magnetic resonance spectroscopy can be a helpful technology to give information of diagnosis and prognosis in neurosurgery for brain injury, brain tumor as well as brain abscess and epilepsy.

In the article we described a case of 61-year-old male with pharyngeal paraesthesia for 3 months. Physical examination: lean physique; vast uneven white membrane above hard palate, soft palate and pharynx mucous membrane, not easy to wipe and extend to the throat. The neck without cervical lymph node enlargement. Blood routine test: WBC 4.92 x 10(9)/L, N 64.3%, L 18.7%, EO 7.1%. RBC 4.08 x 10(12)/L, PLT 181 x 10(9)/L. No significant abnormal in the other blood biochemical indexes, tumor marker and immune indexes; blood bacteria culture: negative; blood culture: negative; sputum culture (3 times): all negative; anti-HIV screening test: positive, serum HIV testing: positive(the test done by Shanghai Pudong new area's centers for disease control and detection). The incidence of HIV/AIDS is still low at present, so the diagnosis of HIV/AIDS can be ignored easily by the otolaryngology doctor. If the patient with oral cavity and pharyngeal ulcer delayed healing, the doctor should be alert to,HIV/AIDS infection. We should check serum HIV antibody to eliminate or confirm HIV/AIDS earlier.
HIV Infections ; diagnosis ; Humans ; Male ; Middle Aged ; Otolaryngology ; methods

DNA damage repair gene mutations are prevalent in advanced prostate cancer. Among these, mutations in homologous recombination repair genes could impair the ability of cell to restore the DNA double-strand break, which can be exploited by Poly-ADP-ribose polymerase (PARP) inhibitors through synthetic lethality and result in cell death. The phase Ⅲ study " PROfound" showed that the PAPR inhibitor Olaparib could significantly improve the survival of patients with homologous recombination repair gene mutations compared with novel hormone agents, starting the era of targeted, precise and individualized treatment based on genetic profile detection for prostate cancer treatment.

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To explore the feasibility of nasolabial sulcus flap transfer with autologous free skin graft to repair the alar defects after malignant tumor resection.Methods From January 2012 to January 2015,9 patients with malignant tumor were treated in the hospital.After complete tumor removal,the defect area being reconstructed was 1.5 cm × 1.3 cm to 2.5 cm × 2.5 cm.The defects of 9 patients were all restored with nasolabial sulcus flap combined with autologous free skin graft.Results The 9 patients were followed up for 6-18 months postoperatively.The nasolabial sulcus flap and autologous free skin graft were survived completely in all cases.Symmetrical alae were noted with slight edema within nasal cavity but without difficult ventilation.Scar was repaired in phase-two surgery.Conclusions Nasolabial sulcus flap combined with autologous free skin graft is an optional way in alar defects restoration.Further with secondary morphologic plasty,satisfactory surgical outcome can be achieved.

Animals ; Apoptosis ; Female ; Male ; Nasal Mucosa ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic, Perennial ; metabolism ; pathology

Objective:To study the pathological mechanism of the inducible co-stimulator molecular and ligand ( ICOS/ICOSL) in Graves disease animal.Methods:45 out-bred BALB/c mice were randomly divided into three groups with 15 rats in each group;using gene gun to deliver different plasmid injection.Group A was delivered with pCDNA3.0-mICOSL and pCDNA3.0-hTSHR, Group B with pCDNA3.0-hTSHR and null pCDNA3.0 with Group C for immunization as the control group.The concentration of serum free thyroxine immunization was deter mined with immunoassay and serum thyrotropin receptor antibody ( TRAb ) with ELISA, supernatant of IFN-γconcentration in mouse spleen cells was measured with radioimmunoassay,and hTSHR transected CHO cells were incubated to detect the concentration of cAMP to deter mine autoantibody TRAb activity.Results: After plasmid injection serum FT4 level in Group A (0.49±0.25) pg/ml ( q=6.571,P=0.023) was higher than that in Group C,the standard rate was higher than Group B and C (χ2=14.47,P=0.005).IFN-γconcentration of mice spleen cultured supernatant in Group A (1.88±0.41) pmol/L was significantly higher than the other two groups.The activity of autoantibody TRAb in Group A 188.3 (179.7-260.2) %was higher than that in the other two groups ( P=0.027 ) .Conclusion: Exogenous delivery of pCDNA3.0-mICOSL plasmid in GD mice could stimulate the spleen lymphocytes to secrete more IFN-γ,increase the activity of TRAb autoantibodies and might lead to upregulation of immune response in Graves animal model in vivo.

AIM:To investigate the influential factors of the blood-brain barrier (BBB) permeability and to observe the effects of zileuton,a selective 5-lipoxygenase inhibitor (5-LO),on focal cerebral ischemia-reperfusion injury (CIRI).METHODS:The right middle cerebral artery of the rat was occluded by inserting a thread through internal carotid artery for 2 h,and then reperfused for 24 h. Zileuton (10,50 mg?kg-1,po) was orally administered 2 h before ischemia and at 0,5,10 h after reperfusion. The permeability of blood brain barrier (BBB) was detected by using Evans blue (EB) as a labelling compound. The degree of cerebral edema was estimated by AutoCAD image analysis software. The mRNA of cysteiny leukotrienes receptor1 (CysLTR1) was detected by RT-PCR. The content of LTB4 in serum was measured by enzyme linked immunosorbent assay (ELISA). The expressions of AQP4 and MMP-9 proteins were measured by immunohistochemical staining method. RESULTS:After middle cerebral artery occlussion 2 h/reperfusion 24 h,the permeability of BBB in the brain tissue of injured side and the brain edema degree were increased. The content of LTB4 in serum was elevated. The expression of CysLTR1 mRNA from the brain tissue of occluded side was enhanced. The expressions of MMP-9 and AQP4 proteins of the ischemia realm and ischemia penumbra (IP) of the infarct focus perimeter were increased. Both 10 and 50 mg?kg-1 doses of zileuton dramatically relieved the BBB permeability destruction and the degree of the brain edema,inhibited the expression of CysLTR1 mRNA in the brain tissue and also reduced the content of LTB4 in serum. The expressions of AQP4 and MMP-9 proteins in the brain tissue were also decreased.CONCLUSION:The permeability of BBB is destroyed after the focal CIRI. The mechanisms of protective effect of zileuton might be attributed to its effects by inhibiting the activation of 5-LO pathways on the brain tissue and circulatory blood,reducing the expressions of AQP4 and MMP-9 proteins of the ischemia and IP realm in the brain tissue.