Objective To assess the effectiveness of balloon dilation and airway stenting performed under fluoroscopic guidance for the treatment of benign and malignant tracheal stenosis. Methods Under fluoroscopic guidance,balloon dilation and airway stenting were performed in 45 patients with tracheobronchial stricture. Of the 45 patients, malignant tracheal stenosis was seen in 37, including mediastinal nodal metastases (n = 14), esophageal carcinoma (n=13), lung carcinoma (n = 4), adenocarcinoma of bronchus (n = 3), lymphoma (n = 2) and laryngocarcinoma (n = 1), and benign tracheal stenosis was seen in 8, including endobronchial tuberculosis (n = 6), retrosternal thyroid adenoma (n = 1) and endotracheal intubation (n = 1). Airway stenting with serf-expandable metal stent was employed in 38 patients and balloon dilation in 7 patients. All the procedures were performed under fluoroscopic guidance. Results A total of 53 self-expandable metal stents was implanted in 38 patients. The clinical symptoms were immediately relived after the procedure in all patients except for one patient who died from choking of sputum. No stent migration was observed. Restenosis developed in 4 patients, which was successfully treated with repeated stenting and balloon dilation. Nineteen times of balloon dilation procedure were accomplished in 7 patients. Marked remission of clinical symptoms was seen in most cases. During a follow-up period (ranged from 0 to 124 months with a mean of 24.5 months) 31 patients died. Conclusion For both benign and malignant tracheal stenosis, balloon dilation with airway stenting performed under fluoroscopic guidance is a safe and efficient therapy with instant curative effect in relieving clinical symptoms.

A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for six months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis.
Diagnosis, Differential ; Epistaxis ; Female ; Hemangioma, Capillary ; diagnosis ; pathology ; Humans ; Nasal Cavity ; physiopathology ; Nasal Obstruction ; pathology ; Nose Neoplasms ; diagnosis ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; diagnosis ; pathology

Objective:To investigate the serum level of miR-224 in hepatocellular carcinoma (HCC) patients and its clinical diag-nostic significance. Methods:The serum level of miR-224 was detected by real-time quantitative PCR. This study included 42 cases of patients with HCC, 36 patients with liver cirrhosis (LC), 55 patients with chronic hepatitis B (CHB), and 40 healthy persons (NC). The relative expressions of miR-224 were calculated. The receiver operating characteristic (ROC) curves were analyzed to determine the sensitivity and specificity of miR-224 expression levels in HCC diagnosis. Results:Result shows that the relative miR-224 expression was higher in the serum of HCC patients than that in the CHB, LC, and NC groups. The difference was statistically significant (P<0.05 or P<0.01). The relative miR-224 expression in the serum of HCC patients and alpha fetoprotein (AFP) were positively correlated (P<0.05). By comparison, the tumor size, TNM stage, tumor differentiation, and lymph node metastasis were not correlated with mirR-224 expression (P>0.05). ROC analysis shows that the best critical value of the relative expression levels of miR-224 was 3.47, with sensi-tivity of 82.2%, specificity of 92.8%, and area under the curve of 0.935. Conclusion:The serum level of miR-224 in HCC patients has high specificity, and miR-224 has great potential to become a new serological marker for the diagnosis of HCC.

OBJECTIVE:To observe the efficiency and safety of budesonide,azithromycin combined with terbutaline in the treatment of infantile acute bronchitis. METHODS:150 children with acute bronchitis were randomly divided into control group(75 cases) and observation group(75 cases). All children were given electrolyte supplement,antiasthmatic,antispasmodic and other conventional treatment;based on it,control group was treated with 10 mg/kg Azithromycin injection,adding into 250 ml 5% Glu-cose injection,by intravenous infusion with time of more than 60 min,once everyday+2 mg Terbutaline sulfate spray solution,add-ing into 2 ml 0.9%sodium chloride injection,aerosal inhalation,twice a day,15 min for every times. Observation group was addi-tionally given 1.0 mg Budesonide aerosol;3 times a day,10 min for every times. The treatment course for both groups was 10 d. FEV1,MEF50,PEF before and after treatment,total effective rate and disappearance time of clinical symptoms,hospitalization time and incidence of adverse reactions were recorded. RESULTS:The total effective rate in observation group were significantly higher than control group,disappearance time of clinical symptoms and hospitalization time were significantly shorter than control group,the differences were statistically significant(P<0.05). After treatment,FEV1,MEF50 and PEF in 2 groups were significant-ly higher than before,and observation group was higher than control group,the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treament,budesonide,azithromycin combined with terbutaline is effective in the treatment of infantile acute bronchi-tis,and it can significantly improve lung function,with good safety.

Objective To investigate incision pathogenic bacteria after spinal surgery, and observe clinical effects of therapeutic methods. Methods A total of 30 cases of early surgical incision infection (7 cases of superficial infection and 23 cases of deep infection) after spinal surgery were retrospectively analyzed. The basic data including clinical manifes-tations, diagnosis, treatment, etiology and follow-up results were analyzed. Results It was found that the mean infection time after operation was 2-15 days in 30 patients. Thirty-three strains were isolated including 18 gram-positive cocci (54.5%, and Staphylococcus aureus account for 13, 39.4%), 15 gram-negative bacteria (45.5%, and Coli communior account for 6, 18.2%). The drug susceptibility test showed that gram-positive cocci were highly sensitive to vancomycin, rifampin, tei-coplanin and cotrimoxazole. No vancomycin-resistant Staphylococcus aureus were found. Gram negative bacteria were high-ly sensitive to imipenem (100%). Seven cases of superficial infection were cured after dressing. Twenty-three cases of deep incision wound infection were no recurrence of infection after treatment by deep wound debridement, and postoperative cathe-terization. Conclusion The early wound infection after spinal surgery is usually due to Staphylococcus aureus. It is good to perform wound debridement, continuous perfusion drainage, and treatment with vancomycin for deep wound infection.

Objective: To analyze the characteristics of imported coronavirus disease 2019 ( COVID-19 ) cases from abroad to Zhejiang Province,so as to provide basis for improving the prevention and control of COVID-19 imported epidemic. Methods: The imported COVID-19 cases reported by Zhejiang Province from September 1, 2020 to January 28, 2021 were extracted from the National Diseases Prevention and Control Information System.The case information were checked with the field epidemiological investigation reports. A descriptive analysis was adopted for the epidemiological characteristics of the imported COVID-19 cases,including time,spatial and population distribution,import source, etc. Results: Zhejiang Province reported 136 cases of COVID-19 from abroad from September 1, 2020 to January 28, 2021, with 38 confirmed cases ( 27.94% ) and 98 asymptomatic cases ( 72.06% ). No deaths and related local cases were reported. A total of 10 confirmed cases and 58 asymptomatic cases were positive for nucleic acid tests at the port of entry, 7 cases were positive after the medical observation period, and the other cases were positive during the medical observation period. Cases were reported in each month. The age of the cases was mainly 20 to 39 years old, accounting for 61.03% (83 cases). The occupations were mainly business services, accounting for 33.09% ( 45 cases ). The 136 imported cases came from 32 countries, among which 26 cases came from Philippines. Most of the imported cases enter China through Hangzhou, Ningbo and Shanghai. Conclusions The imported epidemic situation in Zhejiang Province is sporadic, with large proportion of asymptomatic infections. The imported cases are mainly business service providers and come from Philippines. Therefore, measures such as nucleic acid tests and isolation of entry personnel at ports should be strengthened to prevent the spread of the local epidemic caused by imported cases.

Objective:To explore the application of standardized treatment process for early enteral nutrition combined with gastric retention after operation in patients with esophageal cancer.Methods:Using convenience sampling, 84 patients with gastric retention complicated by early enteral nutrition support after esophagectomy in Department of Thoracic Surgery, Third People′s Hospital of Dalian from July 2015 to June 2020 were selected as the subjects. They were divided into control group and experimental group according to admission time with 42 cases in each group. The control group received routine nursing, while the experimental group received early enteral nutrition and gastric retention standardized treatment process nursing. The differences between the two groups in nutritional status and immune indexes before and 7 days after operation, the standard feeding rate within 7 days after operation, incidence of postoperative complications and enteral nutrition-related complications, length of hospitalization time and hospitalization expenses were compared.Results:In the control group, 2 cases were lost to follow-up. There was no statistically significant difference in preoperative nutritional status and immune indexes between the two groups ( P<0.05); 7 days after operation, the body mass index, serum total protein, prealbumin, nitrogen balance, IgM, CD3, CD4, and CD4/CD8 of the experimental group were all higher than those of the control group, and the differences between the two groups were statistically significant ( t values were 2.228-5.332, P<0.05 or 0.01).The standard feeding rate within 7 days was (68.93±8.12)% in the experimental group and (51.19±6.96)% in the control group, respectively, and the difference between the two groups was statistically significant ( t value was -4.38, P<0.01). The incidence of postoperative nausea and vomiting, Ⅱ B healing, anastomotic fistula and aspiration was 2.38% (1/42), 2.38% (1/42) and 0 (0/42), 2.38% (1/42) in the experimental group and 15.00%(6/40), 7.50% (3/40) and 5.00% (2/40) and 10.00% (4/40) in the control group, respectively, and the differences were statistically significant ( χ2 values were 5.99 - 9.88, P< 0.05 or 0.01). The length of hospitalization time in the experimental group was (10.18±1.69) d, and the hospitalization cost was (53 268.46 ±3 651.56) yuan, both lower than (13.66 ± 2.18) d and (64 972.39 ± 4 029.81) yuan in the control group, and the difference was statistically significant ( t values were 2.14, 2.89, P< 0.05). Conclusions:The standardized treatment process of enteral nutrition combined with gastric retention can improve the feeding rate, nutritional index and immune index within 7 days after operation, reduce postoperative complications and incidence of enteral nutrition related complications, reduce the hospitalization time and reduce hospitalization expenses.

OBJECTIVE:To compare the in vitro dissolubility of four kinds of commercial chlorphenamine maleate tablets. METHODS: To determine the dissolubility of four kinds of domestic commercial chlorphenamine meleate tablets by paddle method and to analyse the dissolution parameters, T50, Td, m, by variance analysis method. RESULTS: The dissolution parame- ters of the different tablets were T50(30. 3 197, 17. 3 695, 20. 1038, l4. 3 651), Td(34. 6 088, 26. 7 162, 28. 0 514, 22. 1 593)and m (2. 7 676, 0. 8 505, 1. 0 992, 0. 8 448). CONCLUSION: The statistical results indicated that there were significant differences between them(P

Objective to evaluate the impacts of 6 standard comparible tables of biparietal diameter(BPD)-gestational age to the second trimester Down syndrome screening and the individual risk rate for pregnant woman. Methods A total of 25 346 pregnant woman with gestational age be-tween 12 to 20 weeks were recruited and analyzed in the study,including 32 Down syndrome. For each pregnant woman,we calculated the gestation-al age by six different BPD-gestational age tables,and the prenatal screening risk value of gestational age. then ROC curve,detection rate and posi-tive rate were used to evaluate the effect of different control tables on the screening results. In addition,individual risk rate was used to determine the influence of gestational age deviation on pregnant woman. Results According to the ROC,we found that our self-designed BPD table had the best AUC(0.972),while the table designed by a hospital in Shanghai had the least AUC(0.923). the difference was significant by statistic test(P =0.045). With the same detection rate of 75%,we found our self-designed table had the least positive rate with only 2.3%,and the cutoff was 1∶280, while the table of Chinese Obstetrics and Gynecology had the highest ratio(4.8%),and the cutoff was 1∶345. Our results suggest that once gesta-tional age is estimated to be higher than actual age,the risk will be higher and the positive rate will increase. However,if gestational age is estimated to be smaller,the risk will be smaller and the negative rate will increase. Conclusion the impacts of different tables on Down syndrome screening are different. Our self-designed BPD table is the most effective to estimate gestational age,and the control table of Hongkong is ranked No.2. the wrong estimation of gestational age will largely affect the individual risk of pregnant woman.

Objective To compare the curative effect of anti-relfux plastic stent and common plastic stent in treatment of malignant biliary obstruction.Method 22 cases of anti-reflux biliary plastic stent implantation and 30 cases of common bile duct stent implantation from March 2013 to April 2016 were selected as study subject, then compare the operation time, one-time success rate, postoperative pancreatitis, cholangitis, patency, differences in survival situation.Result There was no significant difference between the two groups in the aspects of the operation time, one-time success rate of recent cholangitis after surgery, postoperative pancreatitis (P > 0.05), but there was significant difference between the three aspects of long term patency, cholangitis, survival period (P < 0.05).Conclusion The anti-relfux biliary stent has good long-term curative effect in treatment of malignant biliary obstruction, which worth of further exploration and research.