Objective To study the clinical value of preoperative superselective embolization of nasopharyngeal angiofibroma.Methods 14 patients with nasopharyngeal angiofibroma diagnosed by CT and MRI,and proved surgically and pathologically were included in this study.Angiography of bilateral external carotid artery and internal carotid artery as well as vertebral artery was performed in all cases. The external carotid arterial blood supply of tumors were superselectively embolized with 100～300 ?m particles of gelfoam or polyvinyl alcohol(PVA). Surgical resection was performed post-embolization 1 to 3 days. Results The main feeding vessels of tumors were the internal maxillary artery in 9 patients,the internal maxillary artery and ascending pharyngeal artery in 4 patients,the internal maxillary artery,ascending pharyngeal artery and the branches of internal carotid artery in one patient. Preoperative endovascular embolization of the branches of external carotid artery with microcatheter was achieved in all patients. After embolization,tumor stains disappeared completely in 8 patients and partially in 6 patients. The rate of total resection was 92.8%(13/14).The mean amount of haemorrhage during operation was 420 ml and the mean operation duration was 150 min.No major complications were relevant to embolization occurred.Conclusion Preoperative intravascular embolization of nasopharyngeal angiofibroma with microcatheter is a safe and effective method.

Objective To evaluate the value of dual-phase MSCT with 3D reconstruction in the staging and resectability of gallbladder carcinoma.Methods Forty patients with suspected gallbladder carcinoma by clinical examination and routine sonography were prospectively studied with dual-phase MSCT. Of these patients, only 35 who underwent a laparotomy for extended cholecystectomy or a palliative surgery were included in the study. Three-dimensional volume rendering and multiplanar reformation was used for evaluation of the vascular invasion and anatomy. The staging and resectability of lesions determined by CT and the results were compared with operative findings.Results On the basis of the CT findings, 13 tumors were resectable and 22 were unresectable. On surgery, 17 tumors were found to be resectable and the remaining was unresectable. Overstaging by CT occurred in 4 patients due to overassessment of duodenal infiltration, pancreatic infiltration and colonal infiltration. CT had a sensitivity of 76.5, a specificity of 100, an accuracy of 88.6, a positive predictive value of 100 and negative predictive value of 81.8 in determining resectability of gallbladder carcinoma. For the diagnosis of hepatic and vascular invasion, and involvement of bile duct by the tumor, there was 100 correlation between CT and surgery. Vascular variations were found in six of 17 patients who underwent radical cholecystectomy.Conclusion Dual-phase MDCT with 3D reconstruction can predict resectability of gallbladder carcinoma and determine the vascular road map before surgery.

In recent years,considerable progress has been made in the treatment of hematologic malig-nancies.However,most patients will eventually relapse and suffer from severe side effects caused by chemotherapy or radiation.Thus,as a well tolerated,safe,effective and innovative therapy,adoptive cellular immunotherapy e-merges at this very moment.This therapy can kill tumors or control recurrence by reinfusing the in vitro amplifi-cated or treated immune effective cells into the patients.It has been actively used in the treatment of various he-matological malignancies and achieved significant effects,which brings hope for more and more patients with re-lapsed or refractory hematological diseases.

Objective To evaluate the clinical efficacy of transcatheter renal sympathetic denervation(RDN)in the treatment of resistant hypertension.Methods Clinical data of 10 patients with resistant hypertension treated by transcatheter renal sympa-thetic denervation were retrospectively analyzed.The blood pressure and complications were analyzed.Results In all of the 10 pa-tients,systolic and diastolic blood pressure decreased significantly after two weeks compared with preoperative,and further de-creased after 3 months (P <0.05 ).There were no statistical difference of systolic and diastolic blood pressure between 3 and 6 months(P >0.05).Before the RDN,the mean number of antihypertensive drugs was 5.3±0.9.After 6 months which was 3.2±0. 6,and which was decreased significantly compared with the preoperative (P <0.05).No adverse reactions were found.Conclusion The RDN can be quickly and sustained decrease the blood pressure in patients with resistant hypertension.

Objective To develop a highly sensitive and accurate time-resolved immunofluorometric assay (TR-IFMA) for measurement of Dickkopf-1(DKK-1),as a novel serologic biomarker for lung cancer. Methods The study constructed a two-manoclonal-antibody "sandwich"-type assay and the sensitivity, within run CV and between run CV and accuracy were evaluated. Serum DKK-1 concentrations were measured by TR-IFMA in 120 healthy controls, in 72 benign lung disease patients, and in 212 lung cancer patients before surgery. The association between serum DKK-1 levels and clinicopathological features were evaluated. Results A standard curve for DKK-1 TR-IFMA had been developed with good sensitivity (0.08 μg/L). Both within run CV and between run CV were less than 6.5%. Accuracy studies, parallelism and precision data were determined and all found to be satisfactory. The validity of DKK-1 assay was confirmed by the good correlation between the results obtained by TR-IFMA and commercial ELISA (r=0.972, P=0.01). The serum levels of DKK-1 were higher in lung cancer patients 31.93(79.47-18.03) μg/L than in benign lung diseases 15.25(18.41-11.49) μg/L and in healthy controls 13. 90( 16. 91-11.02) μg/L DKK-1 levels were significant associated with the presence of distant metastases, as well as lymph node metastases and TNM stage, but not with patients' age, gender and tumor histology. At the cutoff of 22.63 μg/L, the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the TR-IFMA for lung carcinoma were 68.4%, 92.2%, 82.1% ,90.6% and 72.5%. Diagnostic sensitivity and accuracy were higher for small cell carcinoma than for non-small cell carcinoma (70.7% vs 69.5% and 85.6% vs 80.7%, respectively). Conclusions A highly sensitive and reliable TR-IFMA for DKK-1 has been developed. The determination of serum DKK-1 levels may be useful for diagnosis and tumor staging of lung cancer.

ObjectiveTo investigate clinical features,diagnosis and treatment of hyperlipidemic severe acute pancreatitis(HSAP) in late pregnancy. MethodsA retrospective analysis was made on 12 HSAP cases. ResultsHSAP accounting for 20%(12/60) of severe acute pancreatitis (SAP) cases, develops during the period of 28~36 weeks of pregnancy. There were 5 cases in SAP type Ⅰand 7 cases in SAP type Ⅱ. Multiple organ dysfunction syndrome (MODS) was complicated in 4 cases. HSAP is featured with severe hypertriglyceridemia (29?14)mmol/L, significant systemic inflammatory response syndrome (SIRS), large amount of lipidemic bloody ascites. All cases underwent successful. Cesarean section followed by pancreatic operation and were cured. ConclusionHSAP in late pregnancy is a specific type of SAP with fulminant clinical course leading to fetal distress. Effective management of pregnant hypertriglyceridemia helps to prevent HSAP.

Objective To observe the anti-tumor effect and mechanism of curcumin on triple-negative breast cancer mouse model.Methods Human breast cancer cells MDA-MB-231 were inoculated to the chest subcutaneous fat pad of mice(about 1 million cells in 0.1 mL cell suspension).At day 2 after tumor inoculation,nodules were seen at inoculation site (tumor formation rate being 100％).Forty successfully-modeled mice were randomly divided into low-,middle-,and high-dose curcumin groups (10,20,40 mg/kg) and model control group,10 mice in each group.The medication lasted for 30 continuous days.After medication,the blood was taken out from the orbital venous plexus,and the serum was separated for the detection of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) contents.Spleen was separated for the calculation of organ coefficient,tumor mass was weighed,and the expression levels of Bcl-2 and caspase-3 were detected by Western blotting method.Results Compared with the model control group,caspase-3 expression level was significantly increased in the three curcumin groups(P ＜ 0.05 or P ＜ 0.01),but the contents of TNF-α and IL-6,tumor weight,spleen index and Bcl-2 expression were significantly decreased(P ＜ 0.05 or P ＜ 0.01).Conclusion Curcumin has inhibitory effect on triple-negative breast cancer mouse model through promoting the apoptosis of breast cancer cells.

Objective To describe the status of the self-efficacy and coping styles of tuberculosis patients,analysis the relationship between self-efficacy and coping styles. Methods With the method of convenient sampling, used the general information questionnaire self-designed, General Self-Efficacy Scale (GSES) and Medical Coping Modes Questionnaire (MCMQ) to take questionnaire survey on 132 patients with pulmonary tuberculosis.Applicated SPSS19.0 software for the statistics, and analyzed the relationship between self-efficacy and coping styles on patients with pulmonary tuberculosis. Results The mean score of self-efficacy in 132 pulmonary tuberculosis patients was 24.90 ± 7.04,which was in the medium to low level. The proportion of mediun,lower,higher level of self-efficacy was 44.70% (59/132), 39.40%(52/132),15.90%(21/132).Scores of the coping styles on face,avoid, yield were 21.16±9.23,16.55± 2.83,9.68 ± 4.12.Patients self-efficacy level was positively correlated with face coping style (r=0.242, P<0.05), avoid coping style (r=0.150, P<0.05),and negatively correlated with the yield response (r=-0.008, P<0.05). Conclusions The general self-efficacy level of tuberculosis patients is at a lower level. Tuberculosis patients should have more choice to handle it.

Objective To explore the advantages and disadvantages of helicopter emergency medical services of South China in the long-distance transport for critical patients.Methods A total of 30 patients who received helicopter emergency medical services by Guangdong Generral Hospital from August 2004 to December 2014 were selected as the observation group,and the other 30 patients with similar conditions who received ground emergency medical services were selected as the control group.To analyses the difference between the two groups in the disease,transport distance,transportation time,costs and compliction by χ2-test,t-test and nonparametric test according types of data.Results There were significantly difference between two groups in transport distances (km) [578.0 (313.0,707.5)vs.214.5 (101.5,313.5),P <0.05],set-up time (min) [95.7 (56.7,133.4)vs.10.7 (6.8,15.7),P <0.05],transportation time (min) [112.3 (64.3,152.4) vs.146.8 (67.8,217.5),P <0.05],costs (yuan/h) [14378.5 (9887.0,16348.5)vs.557.0 (356.5, 787.5),P <0.05]and the distance/total time value [2.8 (1.3,4.8)vs.1.4 (0.8,2.8),P <0.05]. There was no significantly difference in the incidence of complications between two groups (χ2 =0.058,P >0.05).Conclusions Helicopter emergency medical services could shorten the transportation time of critical patients on long distance transportation,and improve the efficiency of first-aid.However,there were many disadvantages that need to be improved in the helicopter emergency medical service of China.

Objective To investigate the association of promoter hypermethylation of secreted frizzled-related proteins (SFRPs) in patients with colorectal cancer. Methods The promoter hypermethylation of SFRPs in 20 sporadic colorectal cancer tissues and adjacent mucosa were detected by methylation-specific PCR. The amplified DNA was subcloned into the T-A cloning vector and sequenced. Two colorectal cancer cell lines (HCT116 and SW480) were treated with 5-aza-2' deoxycytidine for demethylation. The promoter hypermethylation and protein expression of SFRPs in colorectal cancer cell lines were detected by methylation-specific PCR and Western blotting. Results It was demonstrated that the hypermethylation of SFRP 1, 2, 4 or 5 was 19/20,17/20,3/20 or 13/20in cancer tissues, respectively, whereas it was 12/20, 8/12, 1/20 or 7/20 in adjacent mucosa,respectively. SFRP 1, 2 or 5 methylation was more frequently found in cancer tissue than in adjacent mucosa (P～0.05). Methylation of SFRP 1, 2, 4 and 5 were found in HCT116 cell line, but only SFRP1 and SFRP2 were found in SW480 cell line. There was a negative correlation between protein expression and methylation of SFRPs. The Western blotting revealed that SFRP protein re-expressedafter it treated with 5-aza-2' deoxyeytidine. Conclusion Methylation of SFRP 1, 2 or 5 gene is associated with the evolution of eolorectal cancer, and is closely related to silencing expression.