Objective To investigate the incidence,original location and clinical features of olfactory sulcus polyp in patients with chronic sinusitis.Methods Two hundred and seventeen cases(351 sides) with chronic sinusitis were reviewed,their olfactory sulcus was carefully examined with nasal endoscope during operation.The incidence and original location of olfactory sulcus polyp were observed,and the relationship between olfactory sulcus polyps and prognosis of chronic sinusitis or olfaction of the patients with olfactory sulcus polyps were also statistically analyzed with Chi-square test and Spearman rank correlation.Results The incidence of olfactory sulcus polyp in the cases with chronic sinusitis was 18.52%.Among these cases with olfactory sulcus polyps,the rate of olfactory disorder was 81.82%,which was higher than that in the cases without olfactory sulcus polyps(25.63%,P

Objective To evaluate the clinical diagnostic value of coronary artery calcification score(CACS)of multi-slice spiral computed tomography(MSCT)combined with carotid intima-media thickness(IMT)measure in elderly patients with coronary artery disease(CAD). Methods　CACS of MSCT,carotid IMT measure,and coronary angiography were performed in 68 patients,including 36 cases with CAD(CAD group)diagnosed by coronary angiography and 32 cases(control group)with coronary arterial stenosis(＜50% stenosis).CACS and carotid IMT were compared between two groups. Results　The coronary artery calcification score was significantly increased in CAD group compared with the control group[(349.5±86.3)vs.(74.7±25.2),t=13.670,P＜0.01],and it was increased with the severity of coronary arterial stenosis.The carotid intima-media thickness in CAD group showed significant difference with that in control group[(1.11±0.05)mm vs(0.69±0.13)mm,t=13.587,P＜0.01].In CAD group,CACS exhibited a significant positive correlation with carotid IMT(r=0.950,P＜0.01).The positive rates of CACS and carotid IMT were both 77.8% (28 cases)in CAD group and both 12.5%(4 cases)in control group,which showed significant difference between two groups(X2=28.976,P＜0.01). Conclusions　CACS of MSCT combined with carotid IMT have high sensitivity and specificity in evaluating coronary arteriaI stenosis.It can be used as a non-invasive examination to diagnose CAD in the elderly.

Objective To study the protective and therapeutic effect of Luotong on the retinal microvessel kinetic morphological changes during various stages of streptozotocin-induced diabetic rats. Methods The diabetic rat model was setup by a single intraperitoneal injection 65 mg/kg of streptozotocin. Diabetic model rats were randomly divided into diabetic model group (6, 9, 12 months subgroups), diabetic group protected with Luotong (6 months) from the onset of diabetic model (LT group)and diabetic group treated with Luotong (3, 6 months subgroups ) 6 months after the onset of diabetic model (LT1, 2 group). The eyeballs were removed at 6, 9 and 12 months, respectively. The whole mounts of retinal digestion were prepared and stained with PAS staining method. The light microscope and transmission electron microscope morphological observations were performed and the basilar membrane thickness of retinal capillaries were quantitatively analysed by LEICA-Q550IW computer image system. Results At 6 months, the retinal microvessel morphological changes of LT group were less severe than those of 6 month model group. At 9 months of the diabetic model rat, the retinal microvessel morphological changes were prominent. 3 months after Luotong therapy, the retinal microvessel changes were partly improved in comparison with 9 month model group but still aggravated gradually. At 12 months, the retinal microvessel morphological changes of diabetic model rats were very severe. 6 months after Luotong therapy, the retinal microvessel changes were significant mitigated compared with 12 month model group. The results of computer image analysis indicated the retinal capillary basilar membrane thickness in diabetic group protected or treated with Luotong were significant decreased in comparison with homeochronous model group (P

Objective To investigate the mechanism of Chinese herbal medicine compound (Kaiyuqingwei Decoction) improving islet cells function of type 2 diabetes. Methods The models of type 2 diabetic rats were established by feeding with high-fat-diet and injecting low dosage of streptozotocin (15 mg/kg BW). Rats were randomly divided into model group, Kaiyuqingwei group, and Rosiglitazone group and normal control was established, at the same time, fasting and post-glucose loading 2 hours blood glucose, serum fructosamine and basal insulin were determined. Euglycemic hyperinsulin clamp technique was adopted to evaluate insulin sensitivity of periphery tissues, and intravenous glucose tolerance test to evaluate islets function. Adopting immunohistochemistry stain (EnVision) and computer image analysis technique to determine the expression of insulin, insulin receptor and insulin receptor substrate-1 in islets. Results There were insulin resistance, dysfunction of islet cells and obvious increase of blood glusose in model rats. All these could be improved by Kaiyuqingwei Decoction and Rosiglitazone. Meanwhile, immunohistochemistry stain of islets demonstrated that Kaiyuqingwei Decoction could increase expression of IRc and IRS-1. Conclusion Kaiyuqingwei Decoction have a certain positive role in improving glucose metabolism of type 2 diabetic rats. The mechanism include two aspects, one is elevation of insulin sensitivity, another is amelioration of dysfunction of islet cells. One of the important mechanisms of amelioration of dysfunction in islet cells is amelioration of insulin signal transduction in pancreatic islets.

Objective To observe the effects of ultrashort wave diathermy on the expression of tumor necrosis factor-α (TNF-α) andBcl-2 in hippocampus, striatum and motor cortex of rats with cerebral ischemia/reperfusion. Methods The model of focal ischemia/reperfusionin Sprague-Dawley rats was induced with intraluminal middle cerebral artery occlusion (MCAO) with nylon monofilament suture. Therats were divided into 3 groups: sham group (n=6), model group (n=6) and ultrashort wave diathermy group (n=6). Brain tissue slices wereimmunohistochemically stained (SABC) to observe the expression of TNF-α and Bcl-2. Results The expression of TNF-α and Bcl-2 in lefthippocampus, striatum and motor cortex was higher in the model group than in the sham group (P<0.01). The expression of TNF-α was lowerbut Bcl-2 was higher in the ultrashort wave diathermy group than in the model group (P<0.05). Conclusion Ultrashort wave diathermycan affect the expression of TNF-α and Bcl-2, which may associate to the neuroprotection from focal cerebral ischemia/reperfusion injury.

The changes of immunoreactive neurotensin (ir-NT) contents in the brain areas, pituitary gland and plasma in the trautized rats were observed by radioimmunoassay. The results showed the significant changes of the ir-NT contents in the hypothalamus, pituitary gland, plasma, injured tissue, hippocampus, central gray and spinal cord in the posttraumatic rats at different intervals. A predominant characterization of the change of ir-NT levels in the brain areas, pituitary gland and plasma, was the dramatical decrease at various times except for the hypothalamus, central gray, and hippocampus with biphasic alterations. The ir-NT contents in the frontal cortex, pons and medulla also displayed changes to different extent under the acute craniocerebral trauma condition These results suggest that NT may play a role in the pathophysiology of traumatic injury.

Objective To explore the effect of angiotensin Ⅱ antagonist on left ventricular hypertrophy(LVH) and insulin resistance in elderly patients with diabetes mellitus and hypertension. Methods One hundred and twenty elderly patients with diabetes mellitus and essential hypertension with LVH by echocardiography entered the study. Patients were randomized into the telmisartan (80～160 mg/d) group or perindopril (4～8 mg /d) group. After treatment of telmisartan or perindopril,patients were followed-up for 8 months.Plasma sample was collected from each patient before and after treatment of telmisartan or perindopril,respectively.Then plasma levels of cholesterol,fasting plasma glucose(FPG), insulin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) were investigated.The echocardiography before and after 8 months of treatment with telmisartan or perindopril were also examined. Results Data were analyzed and showed that: (1)After 8 months of treatment with telmisartan or perindopril, blood pressure was reduced from 159/101 to 142/89 mm Hg(P

Objective To evaluate sleeve gastrectomy with ileal interposition and duodenojejunal bypass for the treatment of nonobese Type 2 diabetes mellitus.Methods Forty one patients of nonobese Type 2 diabetes mellitus underwent sleeve gastrectomy with ileal interposition and duodenojejunal bypass.Fasting glucose ( FPG ),glycosylated hemoglobin ( HbAlc ),fasting insulin and C-peptide,triglycerides (TG),high density lipoprotein(HDL),low density lipeprotein(LDL) were measured preoperatively and on postoperative first,3rd,6th month.Results Mean postoperative follow-up was 9.6 months (range 6-21 months).95％ patients achieved adequate glycemic control (HbAlc ＜ 7％ ) without antidiabetic medication.Fasting glycemia decreased from ( 9.7 ± 0.4 ) mmol/L to ( 6.2 ± 0.3 ) mmol/L ( P ＜ 0.01 ).Glycosylated hemoglobin decreased from 8.1％ ± 1.4％ to 5.8％ ± 0.6％ ( P ＜ 0.01 ).2-hour postprandial blood glucose decreased from ( 13.6 ± 0.7 ) mmol/L to ( 10.6 ± 0.2 ) mmol/L ( P ＜ 0.01 ).Insulin resistance (Homa-R) decreased from 4.8 ± 1.3 to 1.2 ±0.4 (P ＜0.01 ).Fasting C-peptide increased from ( 3.3 ± 1.7 ) ng/ml to (4.9 ± 0.2 ) ng/ml ( P ＜ 0.01 ).Fasting insulin increased from ( 10.2 + 1.4 ) mlu/L to (15.6±0.7) mlu/L(P＜0.01 ).Triglycerides (TG) decreased from (3.1 ±0.5) mmol/L to (1.9 ±0.4) mmol/L ( P ＜ 0.01 ).High density lipoprotein (HDL) increased from ( 1.2 ±± 0.2 ) mmol/L to ( 1.9 ±0.8 ) mmol/L( P ＜ 0.01 ).Low density lipoprotein (LDL) decreased from (3.5 ± 0.3 ) mmol/L to (2.4 ±0.6) mmol/L (P ＜0.01 ).Hypertension was controlled in 3/7 cases.Microalbuminuria resolved in 78％ patients.Retinopathy was improved in 53％ cases.Conclusions Sleeve gastrectomy with ileal interposition duodenojejunal bypass is effective for treatment of nonobese type 2 diabetes mellitus as showed by 6 month's follow-up.

Objective To investigate the appearance and characteristics of hepatic tuberculosis lesions on low mechanical index contrast-enhanced ultrasound. Methods Eight patients with hepatic tuberculosis lesions were studied with conventional ultrasound and contrast-enhanced ultrasound. Lesions,distribution.size,echogenieity,blood flow,enhancement phase,enhancement patterns and intensity were studied. ResuIts Fifteen lesions were found in eight patients. On conventional ultrasound,mean size of the lesions was(21.7±10.7)mm×(30.3±22.4)mm,and 66.7%(10/15)lesions located under liver capdule,and 33.3%(5/15)were in hepatic parenchyma.All lesions were hypoechoic except the largest one (50 mm x 102 mm)which demonstrated heterogeneous.Doppler signals were not demonstrated in all 15 lesions.After administration of SonoVue,satisfied image data were obtained in 13 lesions for aterial phase,and 15 lesions for portal venous phase and parenchyma phase.84.6%(11/13)of the lesions demonstrated hyperenhancing on aterial phase,mean enhancing start time was(8.6±1.6)s,ranging from 5 s to 10 s.and mean enhancing end time was(25.6±2.8)s,ranging from 20 s to 29 s. Of 13 lesions,6 lesions demonstrated circle periphery hyper-enchanCement,5 lesions demonstrated whole hyper-enchancement,and 2 lesions appeared hypoenhancement on arterial phase. All lesions demonstrated either hypoenhancing or non-enhancement on portal venous phase and parenchyma phase. Conclusions Low mechanical index contrast-enhanced ultrasound can reveal the blood flow status of hepatic tuberculous lesions and will facilitate the diagnosis of hepatic tuberculosis.

Objective To objectively analyze the manifestation of sleep disorders in patients with Parkinson' s disease (PD) using polysomnogram (PSG) and multiple sleep latency test (MSLT). Method Twenty-six patients (PD group)with PD and 31 controls without CNS diseases( control group) underwent all night ambulatory video-polysomnographic monitoring and MSLT on the next day. Sleep architecture, mean sleep latency,sleep onset rapid eye movement (REM) periods(SOREMPs) and sleep attacks(Sas) of the two groups were analyzed. Results When compared to the controls, percentage of NREM stage 2 sleep,percentage of REM sleep, mean sleep latency in the PD patient group were significantly decreased (32.8% ±13.1% vs40.2% ±9.1%,t = -2.515;8.6% ±5.3% vs 11.5% ±5.1%,t = -2.054;(9.6 ± 4. 4) min vs ( 15.7 ± 3. 1 ) min, t = - 6. 1 64, all P ＜ 0. 05 ), while arousal index was significantly increased ( (41.8 ± 32. 1 )/h vs ( 28.6 ± 1 1. 0 )/h, t = 2. 151, P ＜ 0. 05 ). The prevalence of excessive daytime sleepiness (EDS; 7/26, 26. 9% ) was higher in the PD patient group than in the controls (1/31,3. 2%; ×2 =4. 764,P＜0. 05). Multivariate linear regression analysis showed that after adjusting for sleep efficiency, apnea hypopnea index, arousal index, decreasing mean sleep latency in PD patients was significantly associated with both age( β = -0. 328) and levodopa equivalents( β = -0. 008; t = -2. 829,-2. 352,all P ＜ 0.05). SOREMPs occurred in 5 of 26 (19.2%) PD patients and Sas occurred in 3 ( 11.5% ) PD patients but did not occur in the controls. Conclusion Changes in sleep architectures and EDS are more common in PD patients. Physicians should be highly vigilant in recognizing Sas, which are uncommon in PD patients.