Objective:To investigate the diagnosis and therapy of space-occupying lesion of middle skull base involving sphenoid sinus.Method:A retrospective analysis was performed. Eighteen patients with extradural space-occupying lesion of middle skull base involving sphenoid sinus underwent transnasal endoscopic surgery.Result:One case of primary empty sella turcica was misdiagnosed as sphenoidal sinus cyst. One case of fibrous dysplasia and one case of meningioma were all misdiagnosed as mycotic sphenoiditis. Total rate of misdiagnosis was 16.7%.Among the 18 cases, 17 cases underwent complete resection of the lesion, and only 1 case underwent major resection of the lesion. The amount of blood loss during surgery ranged between 100 ml and 2500 ml.One case had bacterial meningitis which was cured after corresponding treatment. One case was blind in both eyes. And the other case died of pulmonary embolism.Conclusion:Transnasal endoscopic surgery is feasible and practical to treat benign space-occupying lesion of sphenoidal sinus and extradural lesion of middle skull base involving sphenoidal sinus. Definite diagnosis, accurate location and careful operation are important to complete the surgery successfully.

Objective To explore the application of arm infusion port in breast cancer patients with chemotherapy and the effect of remote management. Methods From May 2016 to September, 25 cases of female breast cancer patients treated with chemotherapy in our hospital were studied. Implanted arm port for chemotherapy drug infusion, the patient's bedside guidance given by a case nurse during hospitalization, after the discharge from the hospital to accept the management of arm port remote education and consultation project group. Results A total of 25 patients implanted with arm port have not occurred phlebitis, deep vein thrombosis, central venous catheter infection and other complications;Patient′s satisfaction degree of quality of life were 100%(25/25);patients and their families on the nursing staff to track service satisfaction were 100%(25/25), too. Conclusions The application and remote management of arm port in patients with breast cancer chemotherapy is worthy of clinical research.

Purpose To investigate the mutation status of KRAS and PIK3CA gene in colorectal cancer (CRC) primary lesions and corresponding liver metastasis and its clinical significance.Methods The gene mutations of KRAS and PIK3CA were detected in 58 cases of primary lesions of CRC and corresponding liver metastasis tissue by real-time PCR.Results The mutation rates of KRAS were 31.03％ (18/58) and 25.86％ (15/58) in primary lesions of CRC and corresponding liver metastasis tissue,respectively,in which G12D was most commonly detected.The mutation rates of PIK3CA were 8.62％ (5/58) and 10.34％ (6/58) respectively,in which the most common mutation site was E545K.Only one case carried simultaneously both mutations of KRAS (G12D) and PIK3CA (E545K).The mutation of KRAS and PIK3CA had a good consistency between primary lesions and liver metastasis.Univariate analysis showed that the mutation of KRAS was related to the primary lesion of tumor location,the quantity of metastasis and the types of tumor (P ＜ O.05),PIK3 CA mutation was associated with the synchronous/metachronous liver metastasis and the quantity of metastasis (P ＜ 0.05).Multivariate Cox regression analysis showed that synchronous/metachronous liver metastasis and the mutation of KRAS were influencing factors for prognosis of CRC.The overall survival of patients with CRC who had simultaneous liver metastases was longer than those with heterotopic liver metastases;the overall survival of KRAS wild-type mutant patients was longer than those of mutant patients (P ＜ 0.05).Conclusion The G12D site of KRAS gene has the highest mutation frequency in CRC,KRAS/PIK3CA mutation has a good consistency of the primary lesions of CRC and corresponding liver metastasis.Primary lesions can be as the source of molecular detection.To achieve individualized treatment,we need to reassess the genetic status of metastasis based on the choice of targeted therapy for precision medicine.

In the process of teaching international students laboratory diagnostics,teaching mode has been actively explored. The management of teaching,the foundation of teaching team,the selection of teaching materials and reformation of teaching mode are the key points that affect the teaching quality directly.

Objective To investigate the clinical significance of fetal tricuspid regurgitation (TR) in the screening of chromosomal abnormalities at the first-trimester. Methods Screening for chromosomal abnormalities was carried out in 1 262 fetuses at 11+0 to 13+6 weeks. Ultrosound was performed to measure crown rump length and nuchal translucency (NT) thickness, and to acquire tricuspid waveform. All the neonates were followed up for 6 months after birth. Results Among the 1 262 fetuses, 68 were found to have TR. TR was present in 54 (4.4%) of the 1 239 chromosomally normal fetuses, and in 14 (61%) of the 23 with chromosomal abnormalities. Cardiac malformations were detectable in 28 fetuses. The prevalence of TR was 64%in those with cardiac malformations and 1.5%in those without cardiac malformations. Conclusions Tricuspid regurgitation is an effective predictor for the detection of fetal chromosomal abnormalities at the first trimester.

Objective The purpose of this study was to evaluate the protective potential of the Aspergillus fumigatus thiore -doxin reductase GliT ( TR) antigen by establishing and optimizing ELISPOT assay for TR antigen-specific T cells ( TR/AST) secreting IFN-γand IL-4 in peripheral blood mononuclear cells ( PBMCs ) and explore the role of TR/AST in invasive aspergillosis ( IA ) . Methods We optimized the reaction conditions of ELISPOT by preliminary checkerboard titration and determined the frequencies of positive spot-forming cells ( SFCs) specifically secreting IFN-γand IL-4 in the PBMCs of 20 healthy individuals with TR as specific stimulant and with PHA and PMA as positive controls ,. Results Checkerboard titration demonstrated the best result of ELISPOT with the TR antigen at the final concentration of 10μg/well and PBMCs at 3 ×105/well.The median frequency of IFN-γSFCs was sig-nificantly higher (15 [3.5, 59.5]) than that of IL-4 SFCs (0 [0, 0]) (P<0.001).TR induced IFN-γresponses in all the 20 healthy donors, including 9 cases of strong IFN-γresponse (SFCs>20/3 ×105 PBMCs), accounting for 45%, but failed to induce IL-4 response in 19 of the healthy individuals . Conclusion The Aspergillus fumigatus TR antigen could induce an immunodominant Th1 response , and therefore might be a potential protective antigen .

Objective To explore the teaching effects of physiology lectures and students' attitude to lectures,their suggestions for contents,forms and other aspects of lectures.Methods Random sampling questionnaire survey was conducted among 500 students of 2008 grade and 2009 grade in Xiangya medical school of central south university.The percentage of the option in the questionnaire was calculated and the findings were directly described.Results All students thought that physiology lectures were necessary.Teachers should arrange lectures which students were interested in,pay attention to inspire thinking and enhance teacher-student interaction.67.6％ of students thought that the knowledge learned from lectures can be used in expanding scientific thinking.Conclusions The lectures are popular among most students,playing an important role in cultivating students' ability of strict scientific thinking.

To improve students' experimental research skills,innovative consciousness,promote the construction of functional experimental center,we established series of “comprehensive,contrivable,innovative” experiments in medical students.

Objective To investigate the status on health‐related knowledge and skills among the patients in the Chongqing area and to provide basis for developing public health‐related knowledge and skills .Methods Seven hundred and sixty‐eight patients from 8 general hospitals were sampled ,using the stratified random sampling method .A cross‐sectional investigation on health literacy was conducted with questionnaire“ health awareness survey of patients”,and SAS8 .0 was used to statistically analyze the data .Results The awareness rate of health literacy in Chongqing was 4 .82% .As for the 3 health literacy related aspects including basic health concept and knowledge ,health lif‐estyle and behaviors ,and the health related skills ,the rates were 16 .28% ,2 .21% and 38 .41% respectively .Besides ,the rate of the 5 as‐pects including health conception ,the prevention of infection ,the prevention of chronic diseases ,the safety and the first aid ,the basic medical treatment of analysis were 10 .68% ,20 .31% ,8 .59% ,23 .57% ,10 .68% respectively .There noticed significant differences in different re‐gions ,education ,profession ,the condition of relatives engaged in medical ,medical insurance category(P<0 .05) .Profession and the condition of relatives engaged in medical were the main influencing factors on the level of health‐related knowledge and skills among the patients(P<0 .05) .Conclusion The prevalence of basic health‐related knowledge and skills is low in Chongqing city and we should make comprehensive interventions to improve health liter of patients .