Objective To investigate a repair method for unilateral complete cleft lip nasal deformities.Methods Based on the fullness of healthy nasal wing,Z-form plasty was designed with a nasal mucous membrane and alar cartilage flap,to prolong its curtate length of the deformed side through overlapping transposition,and then with suspension of the custom-crafted nasal wing to replace its abnormal structure,subsequently,to recover the normal anatomic structure of the nosewing,and to get the nasal deformity repaired.Results A total of 12 patients with the severe nasal deformity were treated by this method.and all had satisfactory results.Conclusion This technique is a good choice for repairing the severe secondary nasal deformity after single complete cleft lip operation.

Collateral circulation actively enables or generates new blood vessels in order to ensure blood supply to the tissues of body when the normal feeding arteries are stenosis or occlusion.This article mainly reviews the assessment methods of collateral circuhtion in ischemic stroke.

Objective:The current study investigated the effects of nesfatin-1 in the hypothalamic paraventricular nucleus (PVN) on gastric motility and the regulation of the lateral hypothalamic area (LHA).Methods:The projection of nerve ?ber and expression of nesfatin-1 were observed by retrograde tracing and fluo-immunohistochemistry staining;The nuclei microinjection and nuclei electrical stimulation,extracellular discharges of single unit neuron were used to observe the effects of nesfatin-1 on the GD neurons;Gastric motility recording in vivo were used to monitor the effects of nesfatin-1 on the amplitude of constriction and frequency of gastric motility in conscious rats.Results:Nesfatin-1 inhibited the majority of the GD-E neurons(1.97± 0.12 Hz vs.1.15± 0.07 Hz) and excited GD-I neurons (1.74± 0.10 Hz vs.3.04± 0.18 Hz) in the PVN,which were weakened by oxytocin receptor antagonist H4928 (GD-E:1.38± 0.08 Hz,P＜0.05 vs.nesfatin-1;GD-I:2.49± 0.15 Hz,P＜0.05 vs.nesfatin-1).Gastric motility experiments showed that administration ofnesfatin-1 in the PVN decreased gastric motility.Retrograde tracing and immunofluorescent staining showed that nucleobindin-2/nesfatin-1 and fluorogold double-labeled neurons were observed in the LHA.Electrical LHA stimulation excited the firing rate of GD-responsive neurons (GD-E:2.06± 0.12 Hz vs.4.23± 0.21 Hz,GD-I:1.61± 0.09 Hz vs.4.83± 0.25 Hz) in the PVN.Pre-administration of an antinucleobindin-2/nesfatin-1 antibody in the PVN strengthened gastric motility,decreased GD-E neurons (1.74± 0.10 Hz vs.3.04± 0.18 Hz) and excited the discharging of the GD-I neurons(4.15± 0.18 Hz vs.4.83± 0.25) induced by electrical stimulation of the LHA.Conclusion:Nesfatin-1 in the PVN could serve as an inhibitory factor to inhibit gastric motility,which might be regulated by the LHA.

OBJECTIVE:To observe clinical efficacy and safety of salmeterol fluticasone combined with tiotropium bromide in the treatment of COPD via different inhalation devices.METHODS:Eighty COPD patients were selected from our hospital during Jan.2014 to Jan.2015,and then divided into trial group and control group according to random number table,with 40 cases in each group.Both groups were given Salmeterol fluticasone inhalant 500 μg,bid+Tiotropium bromide inhalant 18 μg,qd.Control group was given medicine via inhalation device coming with medicine,while trial group was given medicine via gas compression type ultrasonic spray inhalator.Both groups were treated for 1 year.Blood concentration of medicine 0.5 h after medication,mMRC score and COPD acsessment test (CAT) score 3,6,9 months after treatment,the times of acute exacerbation during treatment,FEV1％ before and af ter treatment were all observed in 2 groups.The occurrence of ADR was recorded.RESULTS:Four cases withdrew from trial group and 1 case from control group.After medication,there was no statistical significance in blood concentration of fluticasone,salmeterol and tiotropium bromide between 2 groups (P＞0.05).0.5 h after medication,mMRC score of trial group was slightly lower than that of control group,without statistical significance (P＞0.05);CAT score of it was significantly lower than that of control group,with statistical significance (P＜0.05).The times of acute exacerbation in trial group during treatment was significantly less than control group,with statistical significance (P＜0.05).The decrease of FEV1％ in trial group was slightly lower than control group,without statistical significance (P＞0.05).The incidence of ADR in trial group was significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:For COPD patients,salmeterol fluticasone combined with tiotropium bromide via gas compression type ultrasonic spray inhalator is better than inhalation device coming with medicine in clinical efficacy and safety.

Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

Objective To investigate the clinical features, diagnosis, treatment and prognosis of muhisystemic invasive fungal diseases. Methods Twenty-one patients with multisystemic invasive fungal diseases who were hospitalized in department of infectious diseases from January 2001 to June 2008 were retrospectively reviewed. The pathogenic bacteria, involved organs, underlying diseases, clinical manifestations, treatments and prognoses of muhisystemic invasive fungal diseases were analyzed. Results Among 21 recruited cases, 17 had underlying diseases and 11 were treated with long-term immunosuppressive agents. The main pathogenic bacteria were Cryptococcus neoformans, Aspergillus and Candida parapsilosis. Lung and brain were involved in 16 cases (skin involve in 2 cases and lymph node involved in 1 case simultaneously), lung and lumbar involved in 2 cases, heart valves involved in 2 cases, and liver, spleen and bone marrow involved in 1 case. Eight cases were cured, 6 were improved and 7 died. Conclusions In this study, most of the 21 cases with multisystemic invasive fungal diseases are immunocompromised. The main pathogenic bacterium is Cryptococcus neoformans. The lung and brain are common organs involved. Prognosis is associated with early diagnosis and active anti-fungal treatment.

Objective To study the association between Mycoplasma penetrans (Mpe) infection and clinicopathology of IgA nephropathy (IgAN). Methods Blood samples of 118 IgAN patients, 90 patients with chronic kidney disease (CKD) and 89 healthy people were collected. Mpe DNA in serum was detected by PCR and positive samples were confirmed by Southern blotting. According to Mpe infection, IgAN patients were divided into positive and negative groups. Association between clinicopatholgical features of IgAN and Mpe infection was examined.Results Significantly higher Mpe positive rate was found in IgAN group as compared to CKD and healthy groups (16.0% vs 2.2% and 1.1%, P＜0.01). In Mpe positive group, 42.1% patients presented macroscopic hematuria, which was significantly higher than that in Mpe negative group (P＜0.01). While Mpe negative group had greater proteinuria, higher serum creatinine level, higher Lee grading of pathology compared to Mpe positive group. There were no differences of tubulointerstitial lesions and arteriole hypertrophy between two groups. Conclusions IgAN patients have higher Mpe infection rate than CKD patients and healthy people. Mpe positive IgAN patients have more macroscopic hematuria. Mpe infection may be associated with the pathogenesis of IgAN.

AIM: To investigate the correlation between renal transforming growth factor-?1 (TGF-?1) expression and cellular apoptosis, and effect of tea polyphenols (TP) on TGF-?1 expression and apoptosis. METHODS: Four group animals in a rat model of CsA-induced chronic nephrotoxicity were respectively treated by vehicle (olive oil, 0.1 mL?kg~(-1)?d~(-1), sc), TP (80 mg?kg~(-1)?d~(-1), ig), CsA (15 mg?kg~(-1)?d~(-1), sc) and TP (80 mg?kg~(-1)?d~(-1), ig) plus CsA (15 mg?kg~(-1)?d~(-1), sc). At the end of 28th day of treatment, renal creatinine clearance and tissue pathology were analyzed. The TGF-?1 expression was detected by immunohistochemistry and Western blotting. TUNEL assay, apoptosis-related enzymatic activity caspase-3 were also detected. RESULTS: Compared to CsA-treated rats, the animals treated with CsA plus TP showed a significant increase in the renal creatinine clearance (0.12?0.03 vs 0.22?0.02,P

AIM:To study the effect of Panax quinquefolium saponin (PQS) on cardiomyocyte apoptosis in-duced by thapsigargin ( TG) .METHODS:Primary cultured cardiomyocytes from neonatal SD rats were divided into con-trol group, TG group, PQS (40 mg/L, 80 mg/L and 160 mg/L) +TG group, si-PERK+TG group, and mock+TG group.The cells were treated with 1 μmol/L TG for 24 h to induce apoptosis.The PERK gene in the cardiomyocytes was knocked down by RNAi.The cell viability was detected by CCK-8 assay.Apoptosis was analyzed by flow cytometry.Wes-tern blotting was used to determine the expression of ERS molecules GRP78, CRT, ATF4 and CHOP, anti-apoptosis pro-tein Bcl-2 and pro-apoptosis protein Bax.RESULTS: Compared with control group, TG significantly and the apoptosis, reduced the cell viability (P<0.05), increased the phosphorylation of PERK and eIF2α, increased the expression of GRP78, CRT, ATF4, CHOP and pro-apoptosis protein Bax, and decreased the expression of anti-apoptosis protein Bcl-2 (P<0.05).Compared with TG group, PQS treatment (160 mg/L) significantly reduced the apoptosis and increased the cell viability (P<0.05).All the 3 different concentrations of PQS significantly increased the expression of anti-apoptosis protein Bcl-2 and reduced the expression of pro-apoptosis protein Bax (P<0.05) in a dose-dependent manner.PQS pre-treatment and knockdown of PERK both reduced the protein levels of GRP78, CRT, PERK, p-PERK, eIF2α, p-eIF2α, ATF4, CHOP and pro-apoptosis protein Bax, and increased the expression of anti-apoptosis protein Bcl-2 (P<0.05). CONCLUSION:PQS at concentration of 160 mg/L attenuated cardiomyocyte apoptosis induced by TG.PQS had the simi-lar effect as PERK knockdown on cardiomyocyte apoptosis.The mechanism may be associated with inhibiting PERK-eIF2α-ATF4-CHOP pathway of ERS-related apoptosis.

Objective: To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods: Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results: Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.