Objective To explore the feasibility and efficacy of windowing middle meatus maxillary sinus and the frontal recess of tears to treat complex maxillary sinus under the nasal endoscope.Methods Clinical data of 22 patients with complex maxillary sinus lesions were analyzed retrospectively,which were adopted by the approach surgical treatment of through windowing middle meatus maxillary sinus and the frontal recess of tears.In which varus papilloma in 11 cases,5 cases of fungal maxillary sinusitis,3 cases of hemorrhagic and necrotic polyps,recurrent nasal polyps in 3 patients.After operation,they were all taken CT or MRI examination.Nasal cavity and other sinus lesions were first removed,the maxillary sinus ostium were opened through the nasal passages.Then,the maxillary sinus lesions were removed by the frontal recess of tears operation.Results Through the treatment of postoperative nasal cavity irrigation,these cases were followed up for 6 to 18 months.All cases incisions were healed completely,sinus cavity epithelium and clinical symptoms disappeared gradually.No injuries of nasolacrimal duct and complications such as facial numbness.Conclusion The method of the nasal passages joint the frontal recess of tears to treat the complex maxillary sinus benign lesions is a worthy selection of surgical procedures.Its eye shot is open and convenient operation,it can remove maxillary sinus lesions thoroughly and has fewer complications.

Objective To investigate the association between diabetes mellitus and risks of kidney cancer.Methods The cohort and case-control studies on the association between diabetes mellitus and risk of kidney cancer were analyzed by searching PubMed database within the time limit of Jan.1990 to Oct.2011.Data were selected according to the inclusion and exclusion criteria,and the meta-analysis was performed by using the Cochrane Collaboration's RevMan 5.0 software.Results A total of 14 studies(8 cohort studies and 6 case-control studies) involving 6,645,516 participants met the inclusion criteria.Meta analysis showed that patients with diabetes had a higher risk of kidney cancer compared with the control group without diabetes(OR =1.28,95％ CI 1.10 ～ 1.48,P ＜ 0.05).Stratification study showed that diabetes was associated with an increased risk of kidney cancer in cohort studies(OR =1.32,95％ CI 1.14-1.53,P ＜0.05),but this association was not found in casecontrol studies (OR =1.21,95 ％ CI 0.79-1.84,P ＞ 0.05).Conclusion This meta-analysis indicates a positive association between diabetes and risk of kidney cancer,however,future researches are needed to identify whether diabetes mellitus is an independent risk factor for kidney cancer.

Objective To evaluate the clinical value bronchofiberscope and perfusion in the treatment of multi- drug resistant pulmonary tuberculosis (MDR-TB).Methods Forty-two cases were treated by injecting amikacin (0.4 g), ofloxacin (0.4 g), after cleaning up exudation through bronchofiberscope and catheter intervention combined with chemotherapy therapy, while 37 controls were treated by chemotherapy only.Results By the end of 9 months, the sputum tubercle bacillus conversion rate, radiographical improvement rate were 92.9% and 90.5% respectively in the treated groups,while all these indications were higher than those of control group 62.2% and 59.5% (P

Objective To study the effects of traditional Chinese medicine Zuojin Pill on gastrointestinal system.Methods Through ig giving 0.1％ methyl orange solution,the gastric residual rate was calculated,and the effect of Zuojin Pill on gastric emptying in mice was observed.By ig administration of 5％ carbon powder,the advance rate of carbon powder was calculated,and the effect of Zuojin Pill on intestinal motility in normal mice and the antagonistic effect on intestinal motility hyperfunction induced by neostigmine were observed.Effect of Zuojin Pill on contraction of isolated guinea pig ileum induced by histamine was observed.After D-xylose solution was ig given to rats,the serum xylose level was determined 1 h later,and the effect of Zuojin Pill on rat intestinal absorption was observed.The anti-diarrhea effect of Zuojin Pill was observed by giving castor oil to mice.At the same time,we have made a comparison between Zuojin Pill and Wuji Pill-berberine,to evaluate the rationalization of Zuojin Pill.Results It was obvious in experimental results that Zuojin Pill had a regulating effect on gastrointestinal system.Zuojin Pill dose-dependently inhibited the gastric emptying.Zuojin Pill demonstrated more effective suppression on the accelerated movement induced by neostigmine,but did not inhibit normal intestinal transit in mice.Zuojin Pill markedly inhibited sperm motility in mice.Zuojin Pill concentration-dependently inhibited the contraction intensity of isolated ileum muscles in guinea pigs induced by histamine.Zuojin Pill markedly inhibited diarrhea induced by castor oil.Compared with Wuji Pill-berberine,the effect of Zuojin Pill on gastrointestinal system was more visible in the same dose.Conclusion Zuojin Pill has obvious regulation effect on the gastrointestinal tract,there are indications that the application of Zuojin Pill to clinic is scientific and reasonable.

Objective To observe the effect of finger-pressing combined with conventional rehabilitation therapy on the recovery of upper limb function after stroke.Methods A total of 60 cerebral stroke patients were randomly divided into an experimental group (n =30) and a control group (n =30).All patients were treated with conventional anti-symptomatic drugs but no anti-spasticity ones.The experimental group was given conventional rehabilitation and finger-pressing therapy,while the control group was given conventional rehabilitation only.Both groups were measured the motor function,using the upper-extremity portion of the Fugl-Meyer Scale,and the mean integrated electromyography (iEMG) output of biceps and flexor carpi radialis after the first finger-pressing treatment and 1 month later,so as to observe the immediate and continuous effects of finger-pressing therapy respectively.Results After the first session of finger-pressing therapy,the average Fugl-Meyer score(FMA) (12.63 ± 4.64) of the experimental group was significantly higher than in a pretest (12.13 ± 4.88) (P ＜ 0.05),while the iEMG of biceps (41.64 ± 9.22) and flexor carpi radialis (37.06 ± 7.02) were lower than before (P ＜ 0.01).One month after the treatment,compared with the control group,the average FMA (25.17 ± 5.93) and iEMG of biceps(34.42 ± 7.55) and flexor carpi radialis sEMG(30.63 ± 5.54) in the experimental group were significantly improved (P ＜ 0.01).Conclusions Finger-pressing therapy has significant and immediate effects in improving the upper extremity spasticity of stroke survivors.Combined with conventional rehabilitation therapy it can effectively reduce the upper extremity spasticity in stroke patients and significantly improve the upper extremity function.The combination is superior to conventional rehabilitation alone.

Objective To evaluate the role of protein kinase Cα( PKCα)?nuclear factor E2?related factor 2 ( Nrf2)?heme oxygenase?1 ( HO?1) signaling pathway on endotoxic shock?induced acute lung injury ( ALI) in rabbits. Methods Thirty healthy male New Zealand white rabbits, aged 2 months, weighing 2?0-2?5 kg, were randomly divided into 3 groups ( n=10 each) using a random number table: normal control group ( group C);ALI group ( group ALI);PKCα inhibitor chelerythrine group ( group CHE) . In group CHE, chelerythrine 8 mg∕kg ( in 0?5 ml of DMSO) was injected intraperitoneally, and 30 min later, LPS 5 mg∕kg ( in 2 ml of normal saline) was injected via the auricular vein to induce ALI in ALI and CHE groups. The rabbits were then sacrificed at 6 h after injection of LPS or normal saline, and the lungs were removed for examination of the pathological changes which were scored and for determination of wet∕dry lung weight ratio ( W∕D ratio) , and the expression of Nrf2 and HO?1 protein and mRNA. Results Compared with group C, the pathological score and W∕D ratio were significantly increased, and the expression of Nrf2 and HO?1 protein and mRNA was up?regulated in ALI and CHE groups. The pathological score and W∕D ratio were significantly higher, and the expression of Nrf2 and HO?1 protein and mRNA was lower in group CHE than in group ALI. Conclusion The PKCα?Nrf2?HO?1 signaling pathway is one of the endogenous protective mechanisms underlying endotoxic shock?induced ALI in rabbits.

BACKGROUND:Swan-like memory connector (SMC) can form a three-dimensional fixation on long bone shaft,ensure the stability of fracture ends,and produce a continuous dynamic compressive stress on the fracture ends.Insulin-like growth factorⅠ (IGF-Ⅰ) regulates bone development and metabolism,cell differentiation,as well as mitosis.During the union process of fracture,IGF-I is effective to promote cellular proliferation,stimulate bone formation and result in chondrogenesis.OBJECTIVE:To quantitatively determine the effect of SMC and conventional dynamic compression plate (DCP) on the concentration of local IGF-Ⅰ in the union duration of rabbit humerus fracture.DESIGN,TIME AND SETTING:A controlled observational animal study was performed in the laboratory,Department of Orthopaedics,Changhai Hospital,the Second Military Medical University of Chinese PLA from January to May in 2007.MATERIALS:SMC was Ni-Ti alloy panel,comprising 50%-53% Ni,was customized by Lanzhou Seemine Shape Memory Alloy Co.,Ltd.The temperature of shape recovery was (33±2) ℃.METHODS:Thirty adult New Zealand rabbits were used in this study and were processed into osteotomy.The experiment sides of rabbit humerus were cut and fixed with SMC at random,serving as SMC group,and the other sides were cut at the same position and fixed with DCP,serving as DCP group.Each five animals were put to death at the time points of 2,3,4,6,8,and 12 weeks after internal fixation.Specimens were obtained from the areas that were 0.5 cm besides the fracture line.MAIN OUTCOME MEASURES:Following internal fixation,the contents of local IGF-Ⅰ in the specimens of different time points (2,3,4,6,8,and 12 weeks) were determined in both SMC group and DCP group.RESULTS:In the SMC-treated group,the contents of IGF-I increased 2 weeks after internal fixation,reached the maximum at 6 weeks,and then decreased at 8-12 weeks.In the DCP-treated group,the contents of IGF-Ⅰincreased 2 weeks after internal fixation,reached the maximum at 8 weeks,and then decreased at 12 weeks.No significant differences were found between the SMC group and the DCP group at 2,8,12 weeks after internal fixation (P ＞ 0.05).Compared with the DCP group,the SMC group had a remarkably higher content of IGF-Ⅰ at the time points of 3,4 and 6 weeks (P ＜ 0.05).The difference was the most statistically significant at 4 weeks.CONCLUSION:Compared with conventional DCP,the SMC could better promote the secretion of IGF-Ⅰin fracture and facilitate the fracture union due to the continuous dynamic compressive stress and three-dimensional fixation.

Objective To evaluate the efficacy of metformin(MTF) in treatment of clomiphene (CC)-resistant patients with polycystic ovary syndrome (PCOS).Methods The published articles of randomized controlled trial (RCT) of comparison of MTF combined with CC and CC alone in treatment of CC-resistant PCOS were searched in PubMed,EMBASE,OVID,EBSCO databases and Cochrane Library,and these studies were screened under inclusion and exclusion criteria.The quality of included studies and extract data of comparison of ovulation rates and pregnancy rates were evaluated.And the Meta-analysis using statistic software RevMan 5.0 was completed.ResultTotal of 333 patients in total 8 trials were included.Meta analysis showed that MTF plus CC led to a significantly higher clinical ovulation rate ( OR =7.31,95 ％ CI:2.57 - 20.76,P ＜ 0.05 ) and pregnancy rate ( OR =7.93,95 ％ CI:2.45 - 25.63,P ＜ 0.05 ) than that of CC alone.Conclusion MTF can increase ovulation and pregnancy rates of CC-resistant PCOS women.

Objective To explore the efficacy of modified uvula palatopharyngeal plasty in the treatment of obstructive sleep ap-nea syndrome(OSAHS) .Methods 145 cases of OSAHS patients were treated from June 2006 to June 2010 in our hospital ,of which 54 were treated by traditional UPPP surgery ,and the remaining 91 cases were treated by h-UPPP surgery .Compared its effi-cacy by the preoperative and postoperative polysomnography map (PSG) analysis .Results In 145 cases of patients with OSAHS , the PSG monitoring indicators of 1 year after surgery were compared with preoperative ,and there were significant difference in the apnea total time(AI) ,the breathing hypopnea index(AHI) ,the lowest oxygen saturation(SaO2 )(P<0 .05) .The subjective symp-toms in postoperative recovery process of modified UPPP ,such as dry throat ,open nasal ,nasopharyngeal reflux symptoms were sig-nificantly reduced than that of traditional UPPP surgery .Conclusion h-UPPP surgery have a good effect .

OBJECTIVE:To provide reference for clinical use and revision of drug instruction manual. METHODS:The ambi-guity in drug instructions manual was summarized and countermeasures of revision were presented based on the practical clinical conditions. RESULTS & CONCLUSIONS:The problems of drug instruction manual that may mislead the patients and medical per-sonnel were as follows as controversial main contents,unclear descriptions of instruction,unfocused contents or without key points,one instruction for multiple drugs,obvious or inaccurate translations,words without popularity and standardization and wrong sentence division or non-standard typesetting. It is suggested that the manufacturers should attach highly importance to the re-vision of drug instruction manual;the revisers should understand the meaning of drugs instruction manual and know the subjects;the premarketing instructions should be tested and investigated by necessary persons;the major and cultural quality of revisers should be improved;the approval monitoring should be strengthened and the feedback mechanism should be established to further improve the instructions,guide the medical staff and patients with accurate use of drugs and ensure the safe drug use of patients.