Objective: To evaluate the application of CT in the diagnosis of fracture position and the cause of diplopia after orbital trauma. Methods:The CT findings and the clinical informations of orbital fractures accompanying diplopias in 68 patients (70 orbits) were retrospectively analysed. Results: Orbital fractures in 70 orbits were diagnosed by CT. There were burst orbital floor fractures in 45 orbits ( among them orbital floor fracture combined with medial wall fracture in 15 orbits), non-burst obital floor fractures in 10, medial orbital fractures in 5, zygomatic-orbital fractures in 5, orbit roof fractures in 5. The accuracy of CT in diagnosing orbital fracture was 100 percent. In 68 cases, there were 64 patients with vertical diplopia and 4 with horizontal diplopia . Conclusion: CT can correctly locate the orbital fracture and diagnose the cause of diplopia.

Objective To explore the pathological and imaging features of adenosquamous carcinoma (ASC) of pancreas.Methods Both clinical data and imaging findings in seven cases with pathologically proved ASC of pancreas were analyzed retrospectively.Imaging features were compared with pathological results.Results 1 )The disease mainly occurred in people around 55 years, among the 7 cases ,5 located in the pancreatic head, 2 in the body and tail, with abdominal pain and jaundice as the chief complaint.2)Pathologically, the solid part of the tumor was made up of ductal adenocarcinoma and squamous carcinoma components, with a different rate, while the cystic part was made up of necrosis, liquefaction.3) the imaging of 5 cases with ASC of pancreas in which squamous carcinoma components predominate shows solid and cystic tumors of pancreas, furthermore the ratio of central cystic diameter and the whole tumor diameter increase with the the volum of the tumor.4) There is no partitioning in the cystic part of the tumor, with a few irregular microcyst around it.5 ) The tumor shows a pattern of infiltrative growth, associated dilatation of the common bileduct or pancreatic duct in all cases, pancreatic atrophy in part.6) Squamous carcinoma components of the tumor was the pathologic basis for the formation of the solid and cystic structure in imaging.Conclusions ASC of pancreas is a rare aggressive subtype of pancreatic adenocarcinoma with a worse prognosis than the usual type of ductal adenocarcinoma, although symptoms similar to pancreatic ductal carcinoma.Cases of ASC of pancreas in which squamous carcinoma components predominate have certain characteristic imaging and pathologic features,which is important to early diagnosis.

Epilepsy is a common chronic nervous system disease, about one third of patients with intractable epilepsy, which brings a heavy burden to the society. At present, the specific etiology and drug-resistant mechanism are still unclear. Minimally invasive, reliable and economic biomarkers are of great help to improve the diagnosis and prognosis of drug-resistant epilepsy. In recent years, microRNA has gradually become a research hotspot of intractable epilepsy and is expected to become a biomarker. This paper briefly reviews the microRNA related to intractable epilepsy.

Objective:To explore therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure (CHF).Methods:A total of 98 CHF patients were selected from our hospital from Feb 2012 to Dec 2014. According to random number table,they were randomly and equally divided into control group (received valsartan therapy) and combined treatment group (received valsartan combined carvedilol therapy).Therapeutic effect and incidence rate of adverse reactions were compared between two groups.Results:There were no significant differ- ence in all cardiac function indexes before treatment between two groups (P>0.05 all).After treatment,compared with control group,there were significant reductions in HR [(95±14)beats/min vs.(74±16)beats/min],left ventricular end-diastolic dimension (LVEDd)[(74.9±2.9)mm vs.(50.9±1.7)mm],left ventricular end-sys- tolic dimension (LVESd)[(64.9±3.8)mm vs.(45.7±2.0)mm],left ventricular end-diastolic volume (LV- EDV)[(198.7±60.5)ml vs.(165.9±52.3)ml]and left ventricular end-systolic volume (LVESV)[(148.9± 62.7)ml vs.(111.4±51.7)ml];and significant rise in left ventricular ejection fraction (LVEF)[(34.2±6.5)%vs.(56.9±10.1)%]and stroke volume (SV)[(68.4±5.1)ml vs. (81.5±6.0)ml]in combined treatment group,P<0.05 or <0.01.Total effective rate of combined treatment group was significantly higher than that of valsartan group (91.8% vs.71.4%),P<0.01.There were all no apparent adverse reactions in both groups.Con-clusion:The therapeutic effect of valsartan combined carvedilol is significant and its safety is good in patients with chronic heart failure.

Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.

Stem cells are crucial for embryonic development and in the maintenance of adult cellular homeostasis.Understanding the regulatory network of stem cells,including embryonic and adult stem cells,will allow us to learn the pathogenesis and possibly design novel approaches to treat many diseases (such as cancer and degeneration).The retinoblastoma (Rb) pathway controls cellular proliferation,differentiation and death.More and more evidences support an important role of Rb activity in the biology of stem and progenitor cells.Transiently inactivating Rb pathway might favor the expanding of functional stem cell populations,thus have values in the future stem cell applications.

120 teeth with wedge-shaped defects at subgingival depth of 0 ~2 mm were selected and divided into 3 groups(n =40).Gingival retraction code and EXPASYL gingival retraction paste were used for gingival retraction in the 2 retraction groups,and none retraction was used in the control group.After restoration of the defects,all cases were followed up for 1 year and 2 years.The results were evaluated by modified USPHS criteria.No significant difference was detected for 1 year and 2 year successful rates between the extraction groups(P >0.05).The successful rate in extraction groups was higher than that in the control group(P ＜0.05).

Objective To understand the water quality of centralized water supply in Shanghai and provide the scientific data for further improvement of the health inspection and management of centralized water supply. Methods The management situation of centralized water supply, the water quality of water source, product water and tap water were investigated by using the methods in Analytical Methods for Water and Sanitary Standard for Drinking Water Quality (2001) in Shanghai in 2006. Results The current situation of management of 165 units of centralized water supply including 19 self-supply water plants in Shanghai was satisfactory. The analysis of drinking water showed that COD and total coliform in source water exceeded the standard limit remarkably(the eligible rates were 63.93% and 22.95% respectively), the eligible rates of COD, turbidity and manganese in product water and tap water were 25.45%, 18.18%, 27.88% and 18.06%, 13.89%, 11.81% respectively. Conclusion The results of the present investigation show that in Shanghai the main problems about the water quality are water source contamination by organic pollutants and the undeveloped water treatment.

[Objective]To explore the operative method through the trans-upper-sternal approach in the treatment of the cervicothoracic spinal lesions and evaluate its clinical effects.[Method]From August 1999 to February 2006,11 cervicothoracic patients,8 males and 3 females,age ranged from 17 to 77 years with a mean of 41.5 years underwent the trans-uppersternal approach surgical treatment.There were four traumatic lesions,six tumors and one tuberculosis.The lesions were located at T3,C7~T1 and T1、2 in 1 case respectively,C7 and C6~T1 in 2 cases respectively,T1 in 4 cases.The combined cervicothoracic incision and upper sternotomy were performed for the exposure of the vertebral bodies,then tumor or vertebral body was resected,the spinal cord was decompressed,the spinal column was reconstructed and fixed.Neurologic status was assessed using the Frankel classification.[Result]The duration of follow-up ranged from 10 to 56 months with an average of 31 months.One patient developed chyle leakage of 50 ml one day after surgery and the leakage stopped 2 days after continuous drainage.One patient had transient vocal cord paresis which recovered in 3 months.All patients had their neurological improvement at different level.Nonunion or instrument-related complications were not observed,and the vertebral column had good stability.[Conclusion]The trans-upper-sternal approach gives an excellent exposure of the cervicothoracic junction.It is a technically simple,safe and effective method for anterior decompression,maintenance of anatomic alignment,fusion with bone graft and internal fixation with less complications and trauma.Attention should be paid to avoid injury of the recurrent laryngeal nerve and the thoracic duct.

The effects of cotton roll and the traditional gauze wrapper in the protection of endodontic files were observed.Cotton roll showed firm protection and feasible operation advantages,it was more effective than gauze wrapper in the protection of endodontic files(P<0.01).