Objective To introduce a method and the clinical effects of treating the blocks of nasal-lachrymal ducts by the memory alloy stands without TV monitoring.Methods 15 blocks of nasal-lachrymal ducts of 12 cases were taken radiography of nasal-lachrymal ducts;to fix the position,to put into the conducting threads from the tear spots and introduce the dilators inversely along the threads.And then China-made titanium-nickel memory alloy stands were planted into the nasallachrymal ducts.Results To visit the patients for 1 to 12 months after operation,the radiography showed that the nasal-lachrymal ducts were clear.The symptoms of overflowing tears and pus disappear completely,11 blocks of 9 cases fully recovered,4 blocks of 3 cases were on the mend.Conclusion Interventional treatment of blocks of nasal-lachrymal ducts is easy,safe and effective.

Objective To introduce a new septorhinoplastic method for twisted nose, humped nose and hawk nose as well as deviation of nasal septum, and to evaluate its operative method and effect. Methods The incision of cleft between lateral nasal cartilage and greater alar cartilage was employed in all patients. The method of unilateral mucoperiosteal flap osteotomy was used to correct nasal pyramid deformity, and swinging-door operation was performed to correct the deviation of nasal septum simultaneously. Results The operative results of 36 cases were effective and satisfactory. Postoperative follow-up ranged from one year to fifteen years. Based on the results of follow-up in the 32 cases, no recurrence and complications were found in all the cases. Conclusion This new method for septorhinoplasty avoids the detachment and move of nasal bone and nasal septum cartilage and injury of nasal mucoperiosteum, and maintains the blood supply of nasal bone and nasal septum cartilage. It corrects extero-nasal deformity as well as deviation of nasal septum. The operation is effective in nose aesthetic and ventilatory function.

Objective To observe the clinical therapeutic effects of BaDuanJin exercise on patients with scapulohumeral periarthritis.Methods 72 patients were randomly divided into therapeutic group and control group,with 36 cases in each group.The patients in control group were treated with electroacupuncture and those in therapeutic group were treated with electroacupuncture and BaDuanJin exercise for 4 weeks.Pain degree(VAS)and shoulder ROM(Melle Scores)were evaluated before therapy,2 weeks and 4 weeks after therapy.The patients were followed up for 3 months.Results The VAS scores and Melle scores of both groups after therapy(both at two weeks and four weeks)showed significant difference than those before thempy.The scores after 4 weeks therapy were better than those of 2 weeks therapy.The effects of therapeutic group after 3 months showed better result than controls,but without statistical difference(P>0.05).Conclusion BaDuanJin,as a mild exercise had favorable therapeutic effccts on patients with scapulohumeral periarthritis.

Objective To observe the contrast sensitivity (CS) of patients with branch retinal vein occlusion (BRVO) without involving the macular region.Methods 92 BRVO patients (93 eyes) and 56 cases (112 eyes) without eye diseases (control group) were included in the study.According to different region,BRVO patients were divided into the nasal BRVO group (31 eyes) and temporal BRVO (62 eyes) group,and the average corrected visual acuity was 1.02 ± 0.13 and 0.98 ± 0.12 respectively.According to the type of ischemia,BRVO patients were divided into the nonischemic BRVO group (58 eyes) and ischemic BRVO group (35 eyes),the average corrected visual acuity was 1.01 ± 0.14 and 0.99 ± 0.12 respectively.The average corrected visual acuity of the control group was 1.03 ± 0.11.There was no statistically significant difference of the average corrected visual acuity between nasal BRVO group,temporal BRVO group and control group (F=3.03,P =0.06),and between nonischemic BRVO group,ischemic BRVO group and control group (F=1.60,P=0.20).Contrast sensitivity (CS) was measured by OPTEC 6500 vision tester (Stereo Company,USA) under the standard lighting conditions and different spatial frequencies including low (1.5 and 3.0 c/d),medium (6.0 c/d) and high frequencies (12.0 and 18.0 c/d).Results The CS under each spatial frequency of the nasal BRVO group was the same as the control group (t=4.25,9.48,3.08,5.86,0.94;P＞0.05),but the CS under each spatial frequency of the temporal BRVO group was different from the control group (t=8.59,19.11,10.38,17.28,6.01;P＜0.05).The CS under high spatial frequency of the temporal and nasal BRVO group was statistically different (t=11.42,6.95;P＜0.05).The CS under each spatial frequency of the ischemic BRVO group was different from the control group (t=8.88,10.56,11.64,19.06,6.67;P＜0.05).The CS under 6,12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the control group (t =10.14,11.54,2.82;P＜0.05).The CS under 12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the ischemic BRVO (t=7.52,3.84;P＜0.05).Conclusions The CS of the temporal BRVO and ischemic BRVO decreased more significantly under each spatial frequency.CS is a better indicator to evaluate the visual function than the visual acuity in BRVO without involving the macular region.

Background Pregnancy-induced hypertension syndrome (PIHS) appears retinopathy.Optical coherence tomography (OCT) and contrast sensitivity (CS) has been widely used in ophthalmology, but the application of OCT and CS in PIHS fundus lesions is less reported.Objective This study was to assess fundus changes of PHIS by using OCT and CS.Methods Two hundred and thirty-three eyes of 116 PIHS patients with fundus diseases were enrolled from January 2011 to January 2014 in the Cangzhou Central Hospital.One hundred eyes of fifty normal pregnant women were collected at the same period.Best corrected visual acuity (BCVA), fundus examination, OCT, CS were performed on these subjects.The CS values and BCVA between normal pregnant woment and PIHS patients were compared by independent samples t test.The correlation between BCVA grade and CS grade, OCT grade and CS grade, OCT grade and BCVA grade was calculated by trend x2 test and Gamma rank correlation analysis.The study was approved by the Ethics Committee of Cangzhou Central Hospital, all the subjects signed informed consent.Results OCT results showed that 172 eyes were abnormal (65.15％) ,including 94 eyes with neurosensory serous retinal detachment (54.65％) ,40 eyes with pigment epithelium and the ellipsoid zone change (23.26％) and 38 eyes with optic disc edema,retinal hemorrhage and other changes (22.09％).The CS values in each spatial frequency and the BCVA in the PIHS group were significantly lower than those in the normal control group (all at P ＜ 0.05).The OCT examination result was positively correlated with BCVA in the PIHS group (G=0.807,x2=93.418,both at P =0.000).The CS value under the 6.0 c/d had the best correlation with BCVA (G=0.820,x2=97.397, both at P=0.000).The OCT examination result was positively correlated with CS under the 6.0 c/d(G=0.932,x2 =126.376,both at P=0.000).Conclusions Combination of fundus examination,OCT and CS can objectively and comprehensively assess the morphology and function of retinopathy in PIHS patients,which provide the basis for the clinical diagnosis and timely treatment.

Objective:To detect the effects of polysaccharopeptide(PSP) on MyD88-dependent signaling pathway in EAC tumor-bearing mice,and explore the immunomodulatory mechanism of PSP.Methods: Ehrlich′s ascites carcinoma(EAC) C57BL/6 mice were used to establish the animal model for solid tumor.Mice were divided into two groups:WT group and MyD88-/-group.After 22 days of treatment,quantitative real-time PCR( Q-PCR) ,Western blot and were used to detect the related gene and protein expression of TLR4 pathway in spleens,ELISA were used to detect the terminal effect factors secretion eyeball blood from each group.Results:Related genes and proteins of TLR4 pathway in spleen were up-regulated significantly from two groups.Compared with WT group, related genes and proteins in MyD88-dependent pathway(MyD88,TRAF6,NF-κB,AP-1)was down-regulated in MyD88-/-group(P<0.05).Meanwhile,There was no significant change of the related genes and proteins of MyD88-independent pathway(TRAM,TRIF)in MyD88-/-group( P>0.05 ) .The terminal effect factors secretion of IL-2, IL-6, IL-10, TNF-αand IFN-γin MyD88-/-group were decreased significantly compared with WT group(P<0.05).Conclusion:The immunoregulatory effect of PSP on EAC tumor-bearing mice may be implement through the regulation of MyD88-dependent signaling pathway.

Objective To evaluate the clinical efficacy of oropharyngeal decontamination combined with gastrointestinal excitomotor in preventing hospital-acquired lower respiratory tract infection(HALRTI)in elderly inpatients. Methods Totally 110 elderly inpatients with high risks of HALRTI were randomized into intervention group and control group. Patients of the intervention group were administrated by cetylpyridinium chloride gargle twice daily for gargling(20 mL for each), combined with moshabili three times daily orally(5 mg for each). Exact Sig. l-sided was performed to compare the occurence of HALRTI,and Spearman test was performed to evaluate the correlation between positive rate of the phyarynx swabs and the hospitalized time. SPSS 12.0 software was used for statistical analyzing. Results Patients suffered from HALRTI were 1 case(2.00%)in intervention group and 7 cases(13.73%)in control group respectively,and the difference was of statistical significance(P ＜ 0.05). As hospitalized time went on, the positive rate of the phyarynx swabs microbial culture in the control group increased(r = 0.450, P ＜ 0.05), while the intervention group showed no significant change during the whole intervention time(r = -0.023, P ＞0.05). Conclusion The combined intervention of oropharyngeal decontamination with the gastrointestinal excitomotor may be beneficial to elderly inpatients with high risk of HALRTI in the prevention of HALRTI.

Objective To evaluate the curative effect,adverse reactions and complications of transcatheter uterine arterial embolization (TUAE) therapy for leiomyoma of uterus with three different embolization agents: silk particles, pingyangmycin-lipiodol emulsion (PLE), polyvinyl alcohol (PVA).Methods One hundred and twenty-six patients of uterus leiomyoma were included, who undergoing TUAE treatment with silk particles(54 cases, silk particles group) ,PLE(40 cases,PLE group) and PVA(32 cases, PVA group) respectively.Adverse reactions and complications were recorded until 6-60 months after TUAE treatment.Measured the volume of the leiomyoma by ultrasonic inspection or enhanced computed tomography (CT).Results All clinical symptoms of three groups were relieved, and the volumes of uterus leiomyoma after TUAE treatment of 6,12,24 months in PVA group [(50.84 ± 30.77), (39.92 ± 25.72), (31.24 ± 30.60) cm~3]were less than those in PLE group[(76.24 ± 31.16), (58.21 ± 32.05), (52.48 ± 31.41 ) cm~3]and silk particles group[(69.22 ± 36.22), (68.31 ± 32.42), (68.01 ± 30.12) cm~3].The inferior belly and perineal region pain were most slight in silk particles group, but no significant difference in complications was observed in three groups.The symptom recurrence was 3 cases, 2 cases in silk particles group and 1 case in PIE group.Conclusions Clinical outcome of TUAE treatment with all the three embolization agents is acceptable.Adverse reactions and complications are associated with volume of the leiomyoma and the area being embolized.PVA is superior in prevention of complications and relapse of uterus leiomyoma after TUAE treatment.

Objective To describe the natural history of cervical intraepithelial neoplasia(CIN)Ⅰand the biologic factors associated with the progression of CINⅠ and to analyze the predictive values of p16INK4a protein for the progression of CINⅠ. Methods From August 2010 to July 2013, 104 patients referred for abnormal cytology [≤ low-grade squamous intraepithelial lesion (LSIL); including negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASCUS), LSIL] and high-risk (HR) HPV positive,and were diagnosed CINⅠ by colposcopy-assisted biopsy and followed at 1-year intervals in the First Affiliated Hospital of Nanjing Medical University. In order to analyze the relationship between the progression of CINⅠ with clinical biologic factors, including patient age, cervical cytology before colposcopy, loads of HR HPV, HPV L1 capsid protein, p16INK4a protein,χ2 tests was used to compare the different frequencies of factors in groups of progressed and persisted/regressed CINⅠ, then five factors with progressed CINⅠwere processed into binary logistic regression analysis. Results (1) In the first year of follow-up, among 104 patients(including 15 cases NILM,78 cases ASCUS,11 cases LSIL), 52 cases of them were NILM and HR HPV negative, 30 cases were negative for intraepithelial lesion, 10 cases were CINⅠ, 5 cases were CINⅡand 7 cases were CINⅢ. In total, 82 cases (78.8%,82/104) cases had regressed, 10 cases (9.6%,10/104) persisted, 12 cases (11.5%,12/104) progressed [including 5 cases (4.8%,5/104) progressed to CIN Ⅱ, 7 cases (6.7%,7/104) progressed to CIN Ⅲ, none progressed to invasive cancer]. (2) All patients, 88 cases of them accepted immunohistochemical detection the expression of p16INK4a protein. The result shown that 30 cases (34%,30/88) were positive and 58 cases (66%,58/88) were negative. And 94 cases accepted immunocytochemical detection the expression of HPV L1 capsid protein, 49 cases (52%,49/94) were positive and 45 cases (48%,45/94) were negative. (3) Univariate analysis showed that age of the patient, loads of HR HPV, cervical cytology before colposcopy and the expression of HPV L1 capsid protein were not risk factors of the progression of CINⅠ(all P>0.05) except for the expression of p16INK4a protein (P<0.05). Multivariable analysis found that p16INK4a protein positive was associated with progression of CINⅠ(OR=5.1,95%CI:1.162-22.387,P=0.031). (4) Thirty-one cases were p16INK4a protein positive, 8 cases (27%,8/30) of them progressed,while 4 cases (7%,4/58) of 58 cases with p16INK4a protein negative progressed,in which there were significant difference (P<0.05). The sensitivity was 75%, the specificity was 71%, the positive predictive value was 27%and the negative predictive value was 93%for progression to CINⅡ-Ⅲof p16INK4a protein staining. Conclusions The progression rate of CINⅠwith abnormal cytology (≤LSIL) and HR HPV positive was lower, and there was no progression to invasion at 1-year intervals. Immunostaining of p16INK4a protein as the risk factors of CINⅠprogression could have a role in prediction of CINⅠand the management of high-risk CINⅠ.

Objective To study the imaging manifestati ons and diagnostic evaluation of rounded atelectasis.Methods Imaging manifestation of round atelectasis in 4 c ases confirmed by pathology with complete clinical data,plain chest radiographs and CT were analysed.Results The lesions in 4 cases appeared as circular or el liptic masses with clear boundary,2.6～6.5 cm in diameter,located at subpleura o f lower lobule of lung,accompanied with pleural thickening.There was a acute angl e between the tumor and thickened pleura.The lucency of the lung adjacent to tum or incneased.The cordike structures consisted of blood vessels and bronchil ente red into tumors,which made the lateral boundary of tumor to hilum of lung obscur ed.“comet tail sign”and “air-brochogram sign”were seen in 3 cases.Conclusion The round atelectasis is of typical findings o n plain chest films and CT scans which play a very important role in diagnosis a nd differential diagnosis.