Objective To investigate the clinicopathological features,diagnosis and differential diagnosis of nasopharyngeal carcinoma.Methods Analyzed 96 cases of nasopharyngeal carcinoma clinicopathological characteristics and reviewed the literature.Results Ninety-six cases were non-keratinizing nasopharyngeal carcinoma, the male-to-female ratio was 2.6:1. The mainly clinical symptoms was purulent bloody rhinorrhea and neck mass,which nasal endoscope could be seized,the mass lied in lateral wall of pharynx nasalis,tumor cells was broad-spectrum positive for CK and negative for LCA.Conclusions Nasopharyngeal carcinoma is a common disease in this region,if nasal endoscope biopsy less accurate or the performance is not typical,may be confused with reactive lesion and lymphoma,which should be combined with clinical data,endoscopic features and immunohistochemical characteristics to identify.

Objective To investigate the application of intravascular ultrasonography in guiding the performance of interventional management for coronary true bifurcation lesions. Methods A total of 62 patients with coronary true bifurcation lesions, who were admitted to authors’ hospital during the period from April 2010 to Jan. 2014 to receive double stenting treatment, were included in this study. The patients were randomly divided into intravascular ultrasonography group (IVUS group, n=32) and coronary angiography group(CA group, n=30). The minimal lumen diameter(MLD), the minimal lumen area(MLA), the reference lumen diameter (RLD), the length of the lesion and the diameter and length of the implanted stent were determined, and the results were compared between the two groups. During the follow-up period lasting for 12 months after percutaneous coronary intervention, the incidence of in - stent thrombus, target lesion revascularization (TLR) and major adverse cardiac events were recorded. Results The MLD values of the main artery and branches in IVUS group were higher than those in CA group, but the difference was not significant (P>0.05). The MLA, RLD, the diameter and length of the implanted stent in IVUS group were significantly larger than those in CA group (P<0.05). The incidence of in-stent thrombus, TLR and major adverse cardiac events in IVUS group were lower than those in CA group (P>0.05). Conclusion Intravascular ultrasound- guided double stent implantation for coronary true bifurcation lesions can help optimize the performance of stenting and improve the long-term outcome of percutaneous coronary intervention.

Previous studies have suggested that glutathione-S-transferase π (GST-π) over-expression in the brain tissue is associated with refractory epilepsy. However, whether the change in GST-π level in the peripheral blood is in line with that in brain tissue remains unknown. This study examined the correlation between GST-π in brain tissue and that in peripheral blood in rat models of pilocarpine-induced refractory epilepsy. The animals were divided into drug-resistant group and drug-responsive group according to the response to anti-epileptic drugs. GST-π expression in brain tissue was immunohistochemically determined, while the expression of GST-π in peripheral blood was analyzed by Western blotting. In the hippocampus and cortex, GST-π was mainly found in the cytoplasm and membrane of neurons, and the GST-π expression level was higher in drug-resistant group than in the drug-responsive group and saline control group (P<0.05). Moreover, there was no significant difference between responders and saline control animals (P>0.05). The change in expression of GST-π in peripheral blood showed the same pattern as that in brain tissues, suggesting GST-π might contribute to drug resistance in epilepsy. Importantly, the GST-π over-expression in peripheral blood could be used as a marker for resistance to anti-epileptic agents.

Objectives 99mTc-methoxyisobutylisonitrile (MIBI) SPECT imaging technology was used to observe the condition of tumor cell in-taking imaging agent in the C57BL/6J mice Lewis lung cancer model before and after using Ginsenoside Rg3 (short for Rg3).We aimd so as to discuss the feasibility of using this method to evaluate tumor multidrug resistance (MDR) status.Methods Mice Lewis lung cancer models were randomly divided into Rg3 group and the control group.After applying Rg3,semi-quantitative analysis was made on 99mTc-MIBI SPECT imaging and region of interest (ROI) to observe the multidrug resistance state of tumor and then the results were compared with the detection results of flow cytometry.Results The tumor intake ratio (T/N) difference between the control group and the Rg3 group in imaging,imaging before applying Rg3 and imaging after applying Rg3 were separately 15,60 and 120 min.The differences were statistical significant (P ＜ 0.01).The eliminate indexes (WR) of the control group and Rg3 group were positively related to P-gp protein expression positive cells detected by flow cytometry (P ＜ 0.05).Conclusions 99mTc-MIBI imaging is negatively related to P-glycoprotein (P-gp) expression in mice Lewis lung cancer cells,which can clearly show the multidrug resistance state of tumors and dynamically monitor the effect of Rg3 on multidrug resistance reversion of mice Lewis lung cancer.

A gas chromatography mass spectrometry (GC-MS) method has been developed and fully validated for the simultaneous determination of natural borneol (NB) and its metabolite, camphor, in rat plasma. Following a single liquid-liquid extraction, the analytes were separated using an HP-5MS capillary column (0.25 mm ? 30 m ? 0.25μm) and analyzed by MS in the selected ion monitoring mode. Selected ion monitor (m/z) of borneol, camphor and internal standard was 95, 95 and 128, respectively. Linearity, accuracy, precision and extraction recovery of the analytes were all satisfactory. The method was successfully applied to pharmacokinetic studies of NB after oral administration to Wistar rats.

Objective To study the anatomical structure and the distribution of the right posterior sectional Glissonean pedicle so as to provide the anatomical basis for liver resection of the right posterior section.Method By studying the morphological features of the right posterior sectional Glissonean pedicle through peeling and dissecting 20 adult corpses without liver pathological.Result In 95％ of the right posterior sectional Glissonean pedicles there were shared branches.The angle between the GRL/GRA was 81.4° ± 13.8°.In 30％,the right posterior sectional Glissonean pedicle presented as a Y or a V.In a Y shaped,the angle between G6/G7 was 71 ° ±3.92°.The shapes of 70％ of the right posterior sectional Glissonean pedicle presented as a C.The number of branches at the tertiary level was between 3-8.Conclusion The distribution of the right posterior sectional of the Glissonean pedicle did not entirely fit the description of Couinaud's segments.Obvious individual differences existed.Under this circumstance,understanding the anatomy of the right posterior sectional Glissonean pedicle before carrying out partial hepatectomy would be helpful in reducing surgical risks and postoperative complications.

Objective To monitor ventilator-associated event (VAE) for the first time in an intensive care unit (ICU) in China,understand the applicability,incidence,and clinical significance of VAE in China.Methods Targeted monitoring on VAE was performed among patients ≥18 years and with mechanical ventilation (MV)＞2 days in the ICU of a hospital between January 2014 and September 2015,incidence of VAE was calculated,and patients were grouped according to whether or not they had VAE,prognostic factors were analyzed statistically.Results A total of 1 004 patients were monitored,the total hospital stay was 13 795 days in patients who used ventilator,307 (30.58％) cases of VAE occurred,incidence of VAE per 1 000 ventilator-days was 22.25.Univariate analysis showed that patients with VAE had longer length of ICU stay and MV,and higher mortality rate than patients without VAE when they moved out of ICU (all P＜0.05).Multivariate logistic regression analysis showed that VAE was independent risk factor for length of ICU stay,duration of MV,as well as mortality when patients moved out of ICU(all P＜0.05).Conclusion Judgment of VAE is based on MV parameters,it is more objective and accurate.There is a high incidence of VAE among ICU patients,it may lead to poor clinical outcomes,and has good values for the targeted monitoring on ICU patients in large comprehensive hospitals of China.

Objective To investigate the effects of angelica solution on chronic hypoxic pulmonary hypertension in rats.Methods Thirty SD rats were randomized into normoxic group,hypoxic group and angelica solution-protected group.The model of rat chronic hypoxic pulmonary hypertension was made by method of isobaric hypoxia.Angelica solution were injected before hypoxia,while the other two groups were injected normal saline.After 28d of hypoxia,pulmonary artery pressure were measured.Expressions of proliferating cell nuclear antigen (PCNA) and inducible nitric oxide synthase (iNOS) in pulmonary artery were detected by immunohistochemical staining.The index of wall thickness of rat pulmonary arteriole-percentage of the wall area in the total vascular area(wA%) were measured by a computerized image analyzer.Results The mean pulmonary artery pressure (mPAP) of normoxic group,hypoxic group and angelica solution-protected group were10.50±1.90,35.36±9.11,18.32±2.30 (mm Hg);wA% of the three groups were 52.71±5.16,82.38±8.43,64.58±9.54 (%),mPAP and wA% were significantly higher in the hypoxic group than those in the normoxic group (P<0.01) and angelica solution-protected group (P<0.01).PCNA expression of normoxic group,hypoxic group and angelica solution-protected group were 3.15±1.10,24.50±5.72,12.67±3.46 (%).The PCNA expression in the pulmonary artery was significantly higher in the hypoxic group than those in the normoxic group (P<0.01) and in the angelica solution-protected group (P<0.01).iNOS expression of normoxic group,hypoxic group and angelica solution-protected group were 2.13±1.01,17.33±3.53,37.50±7.04 (%).iNOS expression in the pulmonary artery was higher in the hypoxic group than those in normoxic group (P<0.01),and angelica significantly increased iNOS expression in comparison with the normoxic and hypoxic groups (P<0.01).Conclusion Angelica solution alleviates chronically hypoxia induced pulmonary hypertension in rats by inhibiting the espression of PCNA in pulmonary artery and up-regulating the expression of iNOS.

ObjectiveTo investigate the morning blood pressure surge(MBPS) and its relationship with 24-hour blood pressure variability and anti-hypertensive drugs in middle-aged and elderly hypertensive patients.Methods A total of 521 middle-age and elderly men were surveyed with ambulatory blood pressure monitoring and ambulatory electrocardiograms recordings as well as questionnaire investigation from January 2009 to December 2010.Subjects were divided into MBPS positive group and MBPS negative group according to the level of MBPS[ ＞35 mm Hg (1 mm Hg=0.133 kPa) or ≤35 mm Hg].ResultsIn all the cases,the prevalence of MBPS was 19.4％,of which the elderly and very elderly had higher prevalences ( 18.9％ and 21.8％,respectively) than the middle-aged (5.6％,both P ＜0.01 ).Significant differences could be found in age [ ( 81.6 ± 6.4 ) years vs ( 78.7 ± 9.7 ) years ],day mean systolic blood pressure [ ( 132.8 ± 13.3) mm Hg vs ( 128.8 ±13.3) mm Hg],fasting blood glucose [ (5.96 ± 1.59) mmol/L vs (5.68 ± 1.22) mmol/L] and 24-hour blood pressure variability between the two groups ( all P ＜ 0.05 ).Significant difference could be observed in the prevalence of MBPS between the diuretics-taking group and non-taking group (27.4％ vs 17.6％,P ＜0.05 ).ConclusionsThe elderly hypertensive patients are prone to appear MBPS phenomenon.Fasting blood glucose level,24-hour blood pressure variability may be associated with MBPS.Diuretic antihypertensive treatment may not be conductive for MBPS control.

Background: Tumor markers are widely used in clinical practice and have become important indicators in assessing cancer progress. There is increasing concern that chemotherapy combined with traditional Chinese medicine has effects in decreasing the level of tumor markers. Objective: To investigate the effects of chemotherapy combined with Kangliu Zengxiao Decoction (KLZX), a compound Chinese herbal drug, on tumor markers carbohydrate antigen 50 (CA 50), cytokeratin 19 fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) in patients with advanced non-small-cell lung cancer (NSCLC) and to explore the relationships between clinical efficacy and tumor markers. Design, setting, participants and interventions: Patients were included from Punan Hospital of Shanghai Pudong New District and Longhua Hospital between October 2008 and December 2009. Seventy-four subjects with advanced NSCLC were randomly assigned into treatment group (n=37) and control group (n=37). Patients in the control group were treated with chemotherapy alone while patients in the treatment group were treated with chemotherapy combined with KLZX. Chemotherapy of NP (vinorelbine + cisplatin) was given for two cycles and patients in the treatment group were administered with KLZX during chemotherapy. Main outcome measures: Levels of CA50, CYFRA21-1 and CEA before and after treatment were evaluated and the relationship between changes in levels of tumor makers and tumor size, clinical symptoms and living condition score (Karnofsky score) was analyzed. Results: No patients achieved a complete remission. The disease control rates (complete remission (CR)+partial remission (PR)+no change (NC)) were 89.20% (33/37) and 70.30% (26/37) in the treatment and control group respectively (P<0.05). The levels of CA50, CYFRA21-1 and CEA were clearly decreased in the treatment group after treatment (P<0.05) while also decreased in the patients without progression of disease. There were no obvious changes of CA50, CYFRA21-1 and CEA in the control group, and there was even a trend of increase. Furthermore, the improvement rates of clinical syndrome were 51% (19/37) vs 11% (4/37) (P<0.05) in the treatment group and control group respectively. The total response rates of quality of life were 91.89% (34/37) vs 56.76% (21/37) (P<0.01) in the treatment and control group respectively. Conclusion: Combined chemotherapy with KLZX in treating advanced NSCLC can acquire better stabilizing tumor foci, decrease levels of tumor markers and improve the clinical symptoms and Karnofsky score.