OBJECTIVE To describe the surgical experience in the repair of cerebrospinal fluid (CSF)rhinorrhea treated by endoscopic transnasal approaches. METHODS From Oct. 2003 to Dec. 2008, 38 patients with CSF rhinorrhea were treated. Endoscopic endonasal approaches and surgical techniques in repair of CSF leaks were reviewed in a series of 38 patients included 21 patients with traumatic CSF leakage, 10 patients with spontaneous CSF leakage, and 7 patients with other reasons. RESULTS Followup of 6 months to 3 years after operation, successful rate at first attempt was 92.1%. Two patients needed a second surgical repair and one patient a third surgical repair. The complications included meningitis and acute obstructive hydrocephalus in two patients respectively. CONCLUSION The endoscopic endonasal approaches is the first choice for repair of CSF leakage for its minimal invasive injury and high successful rate. Leakage site identification, site preparation, accurate graft placement and postoperative management are critical to the success of operation.

Objective: To investigate the effects of arginine enriched TPN on proliferation and apoptosis of intestinal epithelial cells. Methods:24 young rabbits were divided into 3 groups: control group,standard TPN group and arginine-enriched TPN group.Rabbits in the control group received free chow and water ad libitum after ligation of the right jugular vein;animals in the other two groups received standard TPN(175kcal/kg?d,200 ml/kg?d) or arginine enriched(2% of total energy) TPN.After 7 days of TPN administration,plasma and ileum were collected for the following tests: ①intestinal morphological changes;②incidence of bacterial translocation;③D-lactic acid level in plasma;④expression of proliferating cell nuclear antigen(PCNA) of epithelial cells;⑤apoptosis of epithelial cells. Results:①The mucosal thickness,villus height and villus surface area in argnine enriched TPN group were significantly higher than those in standard TPN group(P0.05).②The incidence of bacterial translocation in arginine enriched TPN group was significantly lower than that in standard TPN group(P0.05).③The plasma D-lactic acid level in arginine enriched TPN group was significantly lower than that in standard TPN group(P0.05). Conclusion:Arginine plays an important role in maintaining the integrity of gut barrier,reducing the apoptosis of epithelial cells and improving the intestinal cells proliferation.

From the aspects of advantages, barriers, opportunities and challenges, this paper analyzed the environmental factors of Shanghai medical resources serving people in the Pan-Yangtze River Delta. As envisaged by the author, such services will provide medical resources information to patients from outside Shanghai, probe into feasible ways to medical insurance based on experiences drawn from serving such patients, help with the resources integration of medical systems in Shanghai, and probe into the potentials of telemedicine and distant medical e-learning, as well as improve hospital management levels and service functionality.

Humans ; Oral Surgical Procedures ; education ; methods ; Surgery, Oral ; education ; manpower ; trends

Objective Through the analysis of the characteristics of serum lipids metabolism and plasma fi‐brinogen levels in patients with sudden hearing loss ,to investigate the relationship between them with sudden deaf‐ness .Methods A retrospective analysis of 180 cases of patients with sudden deafness (SHL group) ,depending on the type of auditory threshold curve divided into low intermediate frequency drops group (low intermediate frequency group) and 40 cases ,the high frequency drop group (high frequency) 90 cases ,all frequency drop group (group all frequency) 50 cases ,and drawing 180 cases in the same period of hospitalization deviated septum ,vocal cord polyp patients as control group .All patients'triglyceride (TG) ,total cholesterol (TC) ,low -density lipoprotein choles‐terol (LDL -C) ,high density lipoprotein cholesterol (HDL -C) ,glucose (Glu) ,plasma fibrinogen (FIB ) levels were analyzed .Then a meaningful factor multivariate Logistic regression analysis was made .Results There was a statistically significant difference between the two groups'TC ,HDL -C ,LDL -C ,Glu ,and FIB(P<0 .05) .There was no significant difference of TG (P>0 .05) .There was a statistically significant difference between the groups'all frequency and low frequency group and control group TC ,HDL -C ,LDL -C ,FIB(P<0 .05) .There was no sig‐nificant difference between each group of Sudden deafness group and the high frequency group and control group (P>0 .05) .The Logistic regression analysis showed that the LDL ,FIB was the major risk factors associated with the onset of sudden deafness .Conclusion Lipid levels in patients with sudden hearing loss is higher than that of in the normal hearing group .High levels of LDL - C and FIB have close correlations with the patients with sudden deafness ,and the related risk factors for the onset of sudden deafness ,according to threshold curve type ,should choose targeted treatment options .

OBJECTIVE: Through the analysis of coagulation convention and blood routine parameters of sudden hearing loss (SHL) patients, further prove the correlation of sudden deafness and the the inner ear microcirculation, to guide clinical diagnosis and treatment. METHOD: Select 424 patients (448 ears) with sudden deafness in our department to SHL group. According to hearing curve is classified into low intermediate frequency descent group, high frequency drop and full frequency group, and drawing 244 cases in the same period of hospitalization deviated septum, vocal cord polyp patients as control group. All patients' coagulation detection, D-dimer, blood leukocytes, neutrophils and platelet count percentages were analyzed. Then a meaningful factor multivariate Logistic regression analysis was made. RESULT: There was a statistically significant difference between the two groups' prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time measurement, fibrinogen, D-dimer, platelet count, white blood cell, neutrophil ratio(P<0.05); Logistic regression analysis showed that the prothrombin, thrombin time measurement, fibrinogen, D-dimer, neutrophil incidence of sudden hearing loss associated risk factors. CONCLUSION SHL in patients with coagulation dysfunction may be involved in the occurrence of SHL development mechanism, and there is a correlation of the SHL and the dysfunction of inner ear microcirculation.
Blood Coagulation Disorders ; complications ; Ear, Inner ; blood supply ; Fibrin Fibrinogen Degradation Products ; analysis ; Fibrinogen ; Hearing Loss, Sudden ; blood ; complications ; Humans ; Incidence ; Risk Factors

Objective To investigate the ex pr ession of nm23-H1 protein and proliferating cell nuclear antigen (PCNA) in huma n glioma cells. Methods Expression of nm23-H1 and PCNA in 53 br ain gliomas were detected by immunohistochemistry. Results The immunohistochemistry staini ng of nm23-H1 protein in low-grade astrocytomas (grades Ⅰ and Ⅱ) was significantly higher than that in high-grade astrocytomas (grades Ⅲ and Ⅳ). The immunohistochemistry staining of PCNA in high-grade astrocytomas was s ignificantly higher than that in low-grade astrocytomas. Conclusion The lower expression of nm23-H1 protein and the higher expression of PCNA are correlated with the pathological grade of glioma cells. The expression of nm23-H1 may be used as a hopeful marker for predicting the metastastic potential of gliomas.

Humans ; Outcome Assessment (Health Care)

Objective To evaluate the role of heme oxygenase-1 ( HO- 1 ) in inflanmatory responses in septic rats.Methods Seventy-two male Wistar rats,aged 10-14 weeks,weighing 250-300 g,were used in this study.The animals were anesthetized with intraperitoneal 2％ pentobarbital sodium 50 mg/kg.Sepsis was induced by cecal ligation and puncture (CLP).The animals were randomly divided into 4 groups ( n =18 each):control group (C group),CLP group,HO-1 inducer cobalt protoporphyrin Ⅸ (CoPPⅨ) group (Co group) and HO-1 inhibitor zinc protoporphyrin Ⅸ (ZnPPⅨ) group (Zn group).Six rats in each group were randomly chosen at 6,12 and 24 h after operation to collect blood samples,and then the animals were sacrificed to obtain lung tissues at 24 h after operation.The serum levels of TNF-α,IL-6 and high mobility group box 1 (HMGB1) were determined by ELISA.The expression of HMGB1 mRNA in lung tissues was detected by RT-PCR.Another 40 Wistar rats with the same conditions were grouped according to the method mentioned above and the survival curve was drawn.Results Compared with group C,the serum levels of TNF-α,IL-6 and HMGB1 were significantly increased,the expression of HMGB1 mRNA in lung tissues was up-regulated,and the survival rate was significantly decreased in CLP,Co and Zn groups ( P ＜0.05).Compared with group CLP,the serum levels of TNF-α,IL-6 and HMGB1 were significantly decreased,the expression of HMGB1 mRNA in lung tissues was down-regulated,and the survival rate was significantly increased in group Co ( P ＜ 0.05),while no significant change was found in the parameters mentioned above in group Zn ( P ＞ 0.05).Conclusion Inducing the expression of HO-1 is helpful in reducing inflammatory responses in septic rats.

Source data and its source documents are the foundation of clinical research. Proper source data management plays an essential role for compliance with regulatory and GCP requirements. Both paper and electronic source data co-exist in China. Due to the increasing use of electronic technology in pharmaceutical and health care industry, electronic data source becomes an upcoming trend with clear advantages. To face new opportunities and to ensure data integrity, quality and traceability from source data to regulatory submission, this document demonstrates important concepts, principles and best practices during managing source data. It includes but not limited to: (1) important concepts of source data (e.g., source data originator, source data elements, source data identifier for audit trail, etc.); (2) various modalities of source data collection in paper and electronic methods (e.g., paper CRF, EDC, Patient Report Outcomes/eCOA, etc.); (3) seven main principles recommended in the aspect of data collection, traceability, quality standards, access control, quality control, certified copy and security during source data management; (4) a life cycle from source data creation to obsolete is used as an example to illustrate consideration and implementation of source data management.
China ; Data Collection ; standards ; Documentation ; standards ; Information Storage and Retrieval ; methods ; standards