Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective The purpose of this study was to evaluate the practicability and efficiency of iFlow assistant function in lower extremity vascular disease angioplasty.Methods Retrospective analysis to 22 patients with lower extremity vascular disease in our single center from Septmber 2013 to November 2013, 19 males and 3 females with mean age(66.31 ± 7.46)years, iFlow technology was utilized to analyze the Region Of Interest(ROI) Peak Time(PeakTime) in pre-and post-angioplasty of lower extremity artery and assessed the state of vessel stenosis and blood flow perfusion, as well Doppler ultrasound in postoperative was used to double identify iFlow results.The results of vessel lesion, such as state of stenosis and occlusion were diagnosed by two senior doctors individually, as well as ROI Peak Time was recorded by technician.Results The iFlow technique performed that the ROI PeakTime in the region of interest was significantly decreased in postoperative in comparison to pre-angioplasty [(0.48 ± 0.39) s vs.(1.32 ± 0.60) s, t =8.836, P ＜ 0.001].The Doppler ultrasound in postoperative showed that the ankle-brachial index was significantly increased compared within preoperative (0.97 ± 0.16 vs.0.49 ± 0.11, t =-10.205, P ＜ 0.001).The results of iFlow technique in intraoperative were consistent with those of Doppler ultrasound in postoperative.Conclusion iFlow technique is effective to evaluate hemodynamic change of blood flow in vessel lesion in pre-and postangioplasty, which is assistive technique to assess the efficiency and prognosis in angioplasty.

Objective To find the optimal scanning time window and then set up the normal binding potentials (BPs) of 2β-carbomethoxy-3β-(4-fluorophenyl)-(N-11C-methyl) tropane (11C-CFT) DAT PET/CT imaging.Methods Thirty-one healthy volunteers (20 males,11 females,average age:(55.7±2.3) years),who all gave written informed consent,were divided into three age and gender-matched groups according to block randomization.Each group underwent static PET/CT scan in different time windows from 40-60 min,60-80 min to 80-100 min after 11C-CFT injection.To determine the best scanning time window,the ratios of caudate and putamen of all volunteers were analyzed using automatic ROI method (caudate (putamen)/parieto-occipital cotex-1) and compared by one-way analysis of variance and the least significant difference (LSD) t test.The ratio of the same area between different age-groups and gender-groups was compared with independent two-sample t test.Results Ratios of left caudate (2.08±0.06,1.75±0.07and 1.77±0.12 respectively),right anterior putamen (2.33±0.06,1.95±0.09 and 2.08±0.12 respectively)and bilateral posterior putamen (left:1.88±0.66,1.55±0.88 and 1.72±0.09; right:1.98±0.07,1.61±0.09and 1.69±0.12) were all different in three time windows (F=3.588,3.345,4.479,3.557,all P＜0.05).There were significant differences in ratios of left caudate,right anterior and bilateral posterior putamen between 40-60 min and the 60-80 min (all P＜0.05),as well as the ratios of left caudate between 40-60 min and the 80-100 min group (P＜0.05).While no valid differences in ratios of those areas were shown between the groups of 60-80 min and 80-100 min scanning time window (all P＞0.05).DAT densities in right and left side of caudate,anterior and posterior putamen were significantly lower in the group over 60 years of age than those under 60 years (t=-3.260,-3.090,-3.270,-3.190,-2.270,-3.110,all P＜0.05),but were not different between gender-groups (t =0.367,0.522,0.144,0.524,0.166,0.004,all P＞0.05).Conclusions Sixty min after injection of 11C-CFT,the BPs achieve stable stage,so the best scanning time window of 11C-CFT DAT PET imaging was 60-80 min after injection.Identification of normal DAT distribution and understanding of normal BPs of 11C-CFF are necessary before its clinical application.

Objective:To establish a simple and efficient clinical prediction model of moderate and severe obstructive sleep apnea hypopnea (OSAHS) in snoring patients based on the clinical data and morphological measurement data in order to increase the early diagnosis and then early intervention of OSAHS. The prediction model is evaluated by external validation.Methods:A total of 299 subjects from January 2015 to December 2018 were selected to perform polysomngraphy (PSG) in Yangpu Hospital, Tongji University School of Medicine. According to the PSG results, they were divided into moderate and severe OSAHS groups (143 cases) and control groups (156 cases). Clinical complications data and morphological measurement data were collected. The regression equation and ROC curve were established according to the Logistic regression method. Then, another 110 subjects from January 2019 to October 2019 were chosen as verified data group, and used to verify the accuracy of the prediction model. The data of 110 subjects were put into the equation according to risk factors and assignment. The ROC curve was drawn and the area under the curve was calculated. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.Results:The predicted equation was: y = -10.707 86+0.589 60 × sex+ 0.141 61 × BMI+ 1.281 62 × tonsil size degree+ 1.807 43 × modified Mallampati degree′tongue position. The AUC of the ROC curve of prediction model in training set was 0.851(95% CI 0.807-0.895), the sensitivity was 83.9%, the specificity was 79.5%, and the cut-off value was 0.634.The AUC of the ROC curve in validation set was 0.827(95% CI 0.751-0.904) with a sensitivity of 73.3% and a specificity of 86.0%, and an accuracy of 79.1%. Its positive predictive value was 5.238, and negative predictive value was 0.310. Conclusions:The predictive model constructed by the combination of clinically accessible data (sex) and morphological measurement (BMI, tonsil size degree, modifiedMallampatidegree) has a relatively high predictive efficiency for screening snoring patients with moderate and severe OSAHS. The predictive model is proved with good forecast accuracy by the external verification method.

For rapid screening, we constructed two levels pools (primary and secondary pools) of the bacterial artificial chromosome (BAC) library of Chinese fine wool merino sheep. The primary pools were based on the individual 384-well microtiter plate and were prepared with a three-dimensional pooling scheme. Three dimension (plate, row and column) pools were made for each. The secondary pools were based on the entire BAC library. We developed a PCR based strategy to identify positive BACs from sheep BAC library. First, we analyzed secondary pools DNAs, according to the result, we analyzed correlative primary pools. It was one-step screening (66 PCR reactions) that we could screen a single positive clone from 74 000 BACs by our method, or three-step screening (less than 100 PCR reactions) could screen more clones. By one-step screening (66 PCR reactions), we screened successfully a positive clone 373D13 with polymorphism marker BF94-1.
Animals ; Chromosomes, Artificial, Bacterial ; genetics ; Gene Library ; Polymerase Chain Reaction ; methods ; Polymorphism, Genetic ; Sheep ; genetics

Parkinson's disease (PD) is a common neurodegenerative disease,pathogenesis of which is extremely complex.To explore the potential pathophysiological mechanism of PD and find effective treatment methods to improve symptoms,modify the disease and delay the progression are the major problems to be solved urgently.Studies have shown that transcranial magnetic stimulation (TMS) has a broad clinical application prospect,which might help clinicians to explore the pathophysiological mechanism of PD and provide new ideas for exploring new targets for diagnosis and treatment in the future.Meanwhile,TMS might play important roles in the treatment of PD motor and non-motor symptoms through enhancing synaptic plasticity,protecting monoamine neurons,increasing the monoamine neurotransmitter level in the brain,and adjusting the brain network with dysfunction.

OBJECTIVE: To study the significance of calcification in the thyroid papillary carcinoma. METHOD: Retrospectively analyze 88 cases of thyroid papillary carcinoma. RESULT: There was no association between calcification with age,TSH and TNM. But calcification was related to the size of tumor (P < 0.05). In addition, the level of TSH has no relationship with the size of tumor. CONCLUSION Calcification especially microcalcification may have significant relationship with thyroid papillary carcinoma and be directly related to the size of tumor. The larger size of tumor implies the higher possibility of calcification.
Adolescent ; Adult ; Aged ; Calcinosis ; pathology ; Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; pathology ; Thyrotropin ; blood ; Young Adult

OBJECTIVE: To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and 11C-methionine positron emission tomography (11C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. MATERIALS AND METHODS: Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and 11C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or 11C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. RESULTS: The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for 11C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; 11C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. CONCLUSION: The combination of MRS and 11C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and 11C-MET PET approach in clinical applications.
Diagnosis ; Electrons ; Glioma ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Methionine ; Positron-Emission Tomography ; Sensitivity and Specificity

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.