Obiective To research haliztosis and it's pathogeny, so we can achieve the aim to clear up pathogeny and cure the halitosis.Methods 274 chinic halitosis patients were included. Through oral cavity examine and other specialized subject examine,defilite the pathogeny. Then we did system oral treatment for patients who only get oral disease. And to the other patients were treated on specialized methods,and assist oral treatment.Result 231 cases were cured,obviously effective in case 11, efficacious in case 6,the whole effctive rate was 90 5 percent.Conclusion The pathogeny of halitosis is complicated, about 23 4 percent halitosis not caused by oral factors, clear up the pathogeny is the key of treatment.

In contrast to the decreasing prevalence of gastric cancer and esophageal cancer,there has been an alarm rise in the incidence and prevalence of adenocarcinoma of esophagogastric junction during recent literatures.Many discrepancies exists in the current literature,however,regarding the etiology,classification and surgical treatment of the tumor.This confusion is due to a lack of clear current UICC recommendation for the classification and staging.Consequently,the selection of the surgical procedure for tumor is controversial.A clear definition and classification is,therefore,the prerequisite for a discussion of the optimal surgical approach.This review give a detailed description of the related concept and recent advances in treatment of adenocarcinoma of the esophagogastric junction.

Objective To analyze postoperative complications of surgical therapy for deep vein thrombosis (DVT) of the lower extremity. Method From January 2001 to January 2008 vena cava filters were placed in 171 DVT cases before surgery. Fogarty catheter (73 cases), Amplatz thrombectomy device (ATD) (55 cases), Acolysis ultrasound ablation(43 cases) were used to extract the thrombi in iliac and proximal femoral vein. The full extraction of thrombi in distal end was facilitated by compressing and massaging the legs in all cases. Iliac venous stenosis or occlusion was managed by interventional therapy, and temporary femoral arteriovenous fistula were carried out routinly. Result Operations were successful in 157 cases(70 cases in Fogarty group, 52 in ATD group,35 in Acolysis ultrasound ablation group), and failed in 14 cases (3 cases in Fogarty group, 3 in ATD group, 8 in Acolysis ultrasound ablation group). Permanent,retrievable and temporary vena cava filters were placed in 51,32 and 88 cases respectively. Stenosis or occulsions of the iliac vein was found in 143 cases and stents were placed after balloon dilatation in 41 cases. During the operation, residual thrombi was found in 80 cases. Vessel perforation and rupture were complicated in 14 cases, thrombosis adhering in eava vein filters in 18 cases. There was no mortality and no pulmonary thromboembolism. During the follow-up, we found iliae vein restenosis in 21 cases, thrombosis recurrence in 36 cases, stents displacement in 6 cases, and stents fracture in 2 cases. Conclusion Surgical therapy is effective for DVT of the lower extremities.

Objective To investigate the clinical efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) in 112 cases. Methods From September 2011 to June 2015, 112 cases of IVCS (Cockett syndrome) were treated in our hospital with endovascular methods .The case numbers of different CEAP ( clinical etiological anatomical pathophysical ) classifications were C2 (45 cases), C3 (23 cases), C4 (19 cases), C5 (11 cases) and C6 (14 cases).All the cases were diagnosed by venography .The operations started from puncturing the ipsilateral veins .The stenotic degree and compressed intensity of iliac vein were evaluated by the minimum diameter with low pressure balloon .And then a stent was placed into after percutaneous transluminal angioplasty ( PTA) when residual stenosis was more than 50%.The occlusive segment was dilated by 8 mm diameter balloon firstly , and catheter directed thrombolysis treatment was applied if thrombus was detected .The PTA and stenting were performed when the thrombus was completely removed .The improvement of clinical symptoms was observed after operation and the patients were followed up by ultrasound and venograghy . Results Nine cases were given PTA only , and the other 103 cases underwent stent placement . Postoperative venography showed collateral vessels were disappeared in 22 cases, obviously decreased in 56 cases and mildly decreased in 34 cases.The average difference of swelling leg ’s circle was diminished from (2.56 ±0.88) cm pre-operation to (0.93 ±0.71) cm post-operation, while the average area of skin ulcer was diminished from (6.34 ±3.78) cm2 pre-operation to (2.13 ±1.88) cm2 post-operation, all of which were statistically significant (t =20.24 and 7.19,P=0.000).A total of 86 cases were successfully followed up during a period from 2 months to 45 months (average, 19.2 months).The patency rate of treated iliac vein 12 months after operation was 76.2%in the PTA group, and in the PTA with stenting group was 96.7%, 88.6%, and 86.1%, respectively, at 12, 24, and 36 months after operation, in which a statistical significance was detected (log-rank χ2 =30.32, P=0.000).The patency rate in diameter ≥16 mm group was 95.2%and 95.2%, respectively, at 12 and 24 months after operation, while in diameter <16 mm group was 97.0%and 93.3%, respectively, in which no statistical significance was detected (log-rankχ2 =0.39, P=0.532).Thrombotic complication was found in 2 cases during the follow-up period , including 1 case of iliac vein thrombosis at 1 month and 1 case of thrombus in contralateral leg 8 months later .According to the results of venography in 78 cases at 12 months after operation , restenosis was found in 5 out of 6 cases in the PTA group, and the patency rate in the stent placement group was 95.8%(69/72).No stent migration was found . Conclusion Comfortable clinical results were obtained after endovascular therapy for iliac vein compression syndrome , and the application of stenting could increase the middle and long term patency rate of treated vessels .

Objective To explore the influence of middle cerebral artery blood flow on mechanical ventilation in very low birth weight premature after using Budesonide(BUD) mixed with pulmonary surfactant(PS),and to explore the protection mechanism of cerebral injury.Methods Forty premature infants (gestational age ＜ 34 weeks,birth weight ＜ 1 500 g) with respiratory distress syndrome(RDS) were randomly assigned into study group and control group in Nanjing Maternal and Child Health Hospital from Aug.2010 to Mar.2012.PS and BUD mixture was used in study group (Per 70 mg PS adding BUD 0.25 mg),PS dose of 70 mg/kg,BUD dose of 0.25 mg/kg.Control group was only administered with PS,dose 70 mg/kg.It was administered intratracheally after 30 to 60 minutes of birth in both groups.The index of blood flow rate and blood vessel elasticity of arteria cerebri media [including systolic velocity (Vs),diastolic velocity (Vd),mean velocity (Vm),resistant index (RI) and elasticity index (PI)] were monitored by using transcranial Doppler.Results The Vs increased steadily in study group,but instability in control group,and there were of statistical differences on the 4 d,5 d,6 d and 7 d (t =3.21,2.95,3.12,3.43,all P ＜ 0.05).The Vd increased steadily in study group,but unsteadily in control group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =4.21,3.10,3.98,4.56,all P ＜0.05).The Vm of study group was higher than that in the PS group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =2.68,2.98,3.98,3.57,all P ＜ 0.05).The RI of study group was higher than that in the control group,and there were statistical differences in the 5 d,6 d and 7 d(t =3.10,3.98,4.06,all P ＜ 0.05).PI steadily in study group,but instability in control group,and there were statistical differences in the 5 d,6 d and 7 d (t =4.18,3.23,3.02,all P ＜ 0.05).The overall incidence of periventricular/intraventricular hemorrhage showed no significant difference,but severe periventricular/intraventricular hemorrhage (grade Ⅲ,Ⅳ) of study group was less than that in the control group (x2 =4.80,P ＜ 0.05).The incidence of periventricular leukomalacia was reduced in the study group compared with that in the control group (x2 =3.31,P ＜ 0.05).Conclusion The very low birth weight infants treated with mechanical ventilation show steady cerebral blood flow and lower incidence of brain injury after using BUD mixed with pulmonary surfactant.

Objective To study the expression levels of inducible costimulator (ICOS) on CD4+ T cells in peripheral blood in patients with chronic hepatitis B and its change after treated with interferon.Methods All 56 patients were divided into two groups (interferon group has 28 cases,lamivudine group has 28 cases),and interferon group treated by PEG-IFN-α 2a,lamivudine group treated by lamivudine,respectively.There were 20 healthy individuals as control group.The levels of ICOS on CD4+ T cells of patients with chronic hepatitis B were kinetically detected by flow cytometry.The copies of HBV DNA in sera were dynamically detected by real-time PCR.Results The levels of ICOS on CD4+ T cells in patients with chronic hepatitis B was higher than that of normal controls(P＜0.001 ).However,the expressions of ICOS on CD4+ T cells in patients could be deduced by PEG-IFN-α 2a and obviously decreased after treatment.There was significant difference between interferon group and lamivudine group (P＜0.05 in 24 weeks,and P＜0.01 in 48 weeks).After treatment,the change values of ICOS in interferon group was positively correlated with the change copies of HBV DNA (r =0.972,P＜0.001 ).However,the change values mentioned above that did not find correlation in lamivudine group(r=-0.101,P=0.608).Conclusion The study shows the patients with chronic hepatitis B have disordered in cellular immunity and increased with the expression of ICOS on CD4+ T cells.PEG-IFN-α 2a could decrease the expression of ICOS on CD4+ T cells in patients,and correct the Th2 type immune polarization to some extent,and that plays a positive role in antiHBV.

ObjectiveTo discuss the clinical characteristics and therapeutic strategy of acute epidural hematoma(EDH) with mixed density on CT.MethodsThe clinical data of 45 patients with acute EDH with mixed density on the first CT after trauma were analyzed retrospectively.Acute EDH form trauma with mixed density on CT images were compared with those which had homogenesis density on CT images at the same time.ResultsThe opportunity of increasing size of hematoma and the mortality was significantly higher in mixed density hematoma( 82.1％,16.2％ )than that of homogenesis density( 17.7％,2.3％ ) ( all P ＜ 0.01 ).ConclusionEDH with mixed density was a hyperacute EDH.The operation for acute EDH from trauma with mixed density on CT image should be prompt.

Objective To study the efficacy and safety of Solifenacin on female overactive bladder (OAB) symptoms secondary to uncomplicated lower urinary tract infection. Methods Seventy-three adult female patients who had clinically diagnosed as OAB symptoms secondary to uncomplicated lower urinary tract infection were randomly divided into treatment group (41 cases) and control group (32 cases). Treatment group received Solifenacin , 5 mg orally qd , as well as OAB behavioral therapy , but control group was given only OAB behavioral therapy. The overactive bladder syndrome score (OABSS) was evaluated before and after antibiotic treatment in all the patients , and the treatment or observation time lasted four weeks after the antibiotic treatment were deactivated. Then OABSS scoring and the cure rate between two groups were compared. Results OABSS score of treatment group decreased significantly after receiving Solifenacin treatment one week , and the cure rate reached 56.10%, and two weeks later, the cure rate reached 92.68%. OABSS score of control group had no significant change one week after treatment and the cure rate was only 6.25%, but at the fourth week OABSS had decreased significantly and the cure rate reached 37.50%, which was still significantly lower than that of treatment group. There were no drug adverse events during treatment in both groups. Conclusions There is obvious clinical effect of solifenacin on female OAB symptoms secondary to uncomplicated lower urinary tract infection, which is safe and could significantly shorten the course of treatment.

Objective:To investigate the prognostic value of preoperative inflammatory indicators for hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 73 patients with primary HCC who underwent radical partial hepatectomy in the Beijing Tsinghua Changgung Hospital of Tsinghua University from December 2014 to July 2019 were collected. There were 57 males and 16 females, aged from 33 to 81 years, with a median age of 58 years. Results of blood examination indicators at the first time in hospital were determined for patients. Observation indicators: (1) the best cut-off values of?? preoperative inflammatory indicators calculated by the maximally selected rank statistics; (2) follow-up; (3) influencing factors for prognosis of HCC patients; (4) comparison of clinicopathological parameters of HCC patients; (5) comparison of predictive value for overall survival. Follow-up was conducted using outpatient examination and telephone interview to determine postoperative survival of patients up to September 2019. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). The best cut-off values ??for continuous variables were obtained using the maximally selected rank statistics based on survival at endpoint of follow-up. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Kaplan-Meier method was used to calculate survival rates, and Log-rank test was used for survival analysis. Univariate analysis was performed using the Log-rank test. Multivariate analysis was performed using the COX proportional hazard model. The time-dependent receiver operating characteristic curve (ROC) was used to compare the predictive value of independent prognostic factors. Results:(1) The best cut-off values of?? preoperative inflammatory indicators calculated by the maximally selected rank statistics: the best cut-off values of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutrition index (PNI) were 3.46, 131.05, and 45.65. (2) Follow-up: 73 patients were followed up for 31 months (range, 2-57 months). Twenty patients died during the follow-up. (3) Influencing factors for prognosis of HCC patients: results of univariate analysis showed that NLR, PNI, tumor diameter, and tumor differentiation degree were related factors affecting prognosis of patients ( χ2=10.213, 4.434, 5.174, 4.306, P<0.05). Results of multivariate analysis showed that NLR and tumor differentiation degree were independent factors affecting prognosis of patients ( hazzard ratio=4.429, 13.278, 95% confidence interval as 1.662-11.779, 1.056-10.169, P<0.05). (4) Comparison of clinicopathological parameters of HCC patients: of 73 patients, 64 cases had NLR<3.46 and 9 cases had NLR≥3.46. Cases with tumor length >5 cm or ≤5 cm, neutrophils, lymphocytes were 23, 41, (2.9±1.2)×10 9/L, (1.7±0.6)×10 9/L for 64 patients with NLR<3.46, versus 8, 1, (5.8±2.9)×10 9/L, (1.0±0.3)×10 9/L for 9 patients with NLR≥3.46; there were significant differences in above indicators between the two groups ( χ2=7.017, t=2.982, -3.168, P<0.05). (5) Comparison of predictive value for overall survival: time-dependent ROC curves of NLR and tumor differentiation degree for 1-, 2-, 3-, 4-year survival rates had the area under curve of 0.735,0.611, 0.596, 0.574 and 0.554, 0.583, 0.572, 0.556, respectively. NLR had better predictive value for overall survival of patients than tumor differentiation degree. Conclusion:Preoperative NLR is an independent factor affecting prognosis patients, and its predictive efficacy is better than tumor differentiation degree.

Objective To explore the changes of rabbit adipose stem cells(ASCs)and bone mesenchymal stem cells(BMSCs)cultured in vitro and the anabolism under basic fibroblast growth factor(bFGF).Methods BMSCs and ASCs were cultured with DMEM,DMEM/F12(2∶1)or α-MEM respectively.The 3rd generation ASCs and BMSCs were divided into 2 groups respectively:group A:ASCs cultured in chondrogenic medium(CM),group B:ASCs cultured in CM supplemented with bFGF 5 ng/ml,group C:BMSCs cultured in CM,group D:BMSCs cultured in CM supplemented with bFGF 5 ng/ml.Morphological changes were observed under inverted microscope.The 35SO42-incorporation and total hydroxyproline were measured.Results BMSCs and ASCs showed much higher growth rate when cultured in α-MEM medium comparison with that in DMEM or in DMEM/F12(2:1).Both stem cells attachment cultured in monolayer greatly increased and cell clones were abundant,while the cells attachment became rather difficult and cell clones were less after cutured in CM.All stem cells possessed a round-like morphology,and the cells in group B and D were more than that in the other 2 groups.The 35SO42-incorporation and total hydroxyproline synthesis of group B or D increased compared with that of group A or C,but there was no diference between group D and B.Conclusion The rabbit ASCs and BMSCs cultured in CM suppling with bFGF grow well and their metabolism increased.