OBJECTIVE To assess the skills and key points with frontal ostium in Draf IIa endoscopic frontal sinus surgery.METHODS We retrospectively reviewed 607 cases of patients who underwent endoscopic sinus surgery between September, 2004 and December, 2007, 84 cases(147 sides)of patients who underwent Draf IIa endoscopic frontal sinus surgery.The period of follow-up were 7 to 40 months.RESULTS All of 84 cases(147 sides) of patients, frontal ostium drainage was restored in 58 cases(102 sides, 69%), improved in 16 cases(28 sides, 19 percent), invalid in 10 cases(17 sides, 12%).CONCLUSION Endoscopic sinus surgery is an effective way for the treatment of chronic frontal sinusitis.Draf IIa endoscopic frontal sinus surgery is an easy and useful technique to restore the drainage of frontal ostium.

Objective To investigate the role of Notch signaling in the progression of peritoneal fibrosis in a rat model induced by high glucose dialysate. Methods Male Sprague Dawley rats were subjected to daily peritoneal dialysis (PD) with a lactate-buffered solution containing 4.25% glucose. They were sacrificed at 2 and 4 weeks after PD. The parietal thickness was measured with Masson staining. The expression of TGF-β1, E-cadherin, α-SMA and collagen Ⅰ was examined by immunoblotting. The expression of Notch ligand Jagged-1 and the negative Notch signaling regulato--Numb was analyzed by both immunoblotting and RT-PCR. The expression of a Notch nuclear target gene Hcs-1 was examined by RT-PCR. Results Both HE and Masson trichrome staining revealed an increase in peritoneal thickness with a loss of mesothelial cells and a rich of collagen matrix deposition in the submesothelial zone was evident at 4 weeks after PD. Meanwhile, compared to healthy rats, the expression of TGF-β1, ct-SMA and collagen Ⅰ was significantly increased, but the expression of E-cadherin was decreased in peritoneum after PD treatment. It was difficult to detect the Jagged-1 and Hes-1 expression in normal peritoneum, but their expression was graduaUy increased after PD. In contrast, the expression level of Numb, a negative regulator of Notch signaling, was dramatically decreased after PD. Conclusions Notch signaling is activated during the process of PD-induced peritoneal fibrosis and the activation of Notch signaling is associated with the loss of negative regulation of Notch signaling via decreased expression of Numb. Inhibition of Notch signaling via overexpression of its negative regulators such as Numb may be a novel therapeutic approach for peritoneal fibrosis in PD patients.

OBJECTIVE To study the changes of symptoms and signs of laryngopharyngeal reflux diseases(LPRD) after treatment with esomeprazole.METHODS The suspected LPRD patients were treated with esomeprazole for 8 weeks.Reflux finding score(RFS) and reflux symptoms index(RSI) score were evaluated before and after treatment.RESULTS In RSI,84％ of the patients had the symptom of hoarseness or a problem with voice,87％ had clearing of throat,71％had excess throat mucus,58％ had difficulty swallowing food,52％ had coughing after eat or after lying down,68％ had breathing difficulties or chocking episodes,79％ had troublesome or annoying cough,92％ had lump in your throat or sensation of something sticking in throat,and 32％ had heartburn,chest pain,indigestion or stomach acid coming up.In the RFS,45％ of the patients had pseudosulcus,57％ had ventricular obliteration,94％ had erythema/hyperemia,85％ had vocal cord edema,82％ had diffuse laryngeal edema,83％ had posterior commissure hypertrophy,10％ had granuloma/granulation,and 58％ had thick endolaryngeal mucus.The RSI and RFS score had statistical difference before and after treatment(P＜0.001).CONCLUSION The main symptoms of LPRD were lump in throat or sensation of something sticking in throat,clearing of throat and hoarseness or a problem with voice.The main signs of LPRD were erythema/hyperemia,vocal cord edema and posterior commissure hypertrophy.The PPI has marked improved in symptoms and signs of LPRD.

Objective To investigate whether the co-culture of Huh7.93 cells and peripheral blood mononucleated cells from chronic hepatitis B patients (cPBMCs) can simulate the replication features of hepatitis B virus (HBV) and immune function in chronic hepatitis B (CHB) patients,and to provide an in vitro cell co culture system for the research on immune clearance in chronic HBV infection.Methods Huh7.93 cells were cultured alone or co-cultured with peripheral blood mononucleated cells from healthy people who underwent physical examination (nPBMCs) or cPBMCs for 7 days.The CCK8 assay was performed to measure the proliferative activity of Huh7.93 cells,and quantitative real-time PCR and Southern blot were used to measure HBV replication in cPBMCs and co-cultured cells.The independent samples t-test was used for comparison between two groups.Results When Huh7.93 cells were co-cultured with peripheral blood mononucleated cells (PBMCs) at a certain ratio,Huh7.93 cells had a high proliferative activity and good cell growth.HBV could not infect or replicate in cPBMCs.HBV DNA in the supematant of Huh7.93 cells co-cultured with cPBMCs showed significant increases and significantly higher than that in the supernatant of Huh7.93 cells cultured alone on day 4 (6.01 ± 0.20 log10copies/ml vs 4.99 ± 0.08 lOg10copies/ml,P =0.000) and day 7 (7.82 ± 0.24 log10copies/ml vs 6.96±0.09 log10copies/ml,P =0.000).On day 7 of culture,the cell lysis buffer of Huh7.93 cells co-cultured with cPBMCs had a significant increase in the level of HBV replicative intermediate compared with that of Huh7.93 cells cultured alone.After HepG2.2.15 cells were co-cultured with cPBMCs,there was no significant increase in HBV replication.Conclusion The co-culture of Huh7.93 cells and cPBMCs produces similar viral replication as human body infected with HBV and can well simulate the liver microenvironnent and immune function in CHB patients,which provides a new method for the research on immune clearance in chronic HBV infection.

Objective To investigate the clinical features and autoantibody characteristics of patients with drug-induced liver injury (DILI). Methods A retrospective analysis was performed for the patients with abnormal liver function who were admitted to Beijing Ditan Hospital, Capital Medical University, from September 2014 to September 2018 and were diagnosed with DILI based on RUCAM score, and related data on admission were collected, including baseline liver function, renal function, routine blood test results, five immune indices, autoantibody, and liver biopsy results. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used to compare the detection rate of autoantibody between the patients with different sexes or types of liver injury. A logistic regression analysis was used to investigate whether autoantibody had a regression relationship with sex, age, and type of injury, and an ordinal logistic regression analysis was performed with baseline laboratory results as independent variables and anti-nuclear antibody (ANA) titer as the dependent variable. Results A total of 419 patients with DILI were enrolled in the study, with a median age of 47 (35-55) years, among whom male patients accounted for 32.5% (136/419) and female patients accounted for 67.5% (283/419). Among these 419 patients, 88 (21.5%) had hepatocellular-type liver injury, 87 (21.2%) had mixed-type liver injury, and 235 (57.3%) had cholestasis-type liver injury. The detection rate of autoantibodies was 50.6% (212/419), and the detection rate of ANA was 42.9% (180/419), with a titer of mainly 1∶ 100 (104/180). There was no significant difference in the detection rate of autoantibodies between the patients with different sexes ( χ 2 =2.658, P =0.103) or different types of injury ( χ 2 =0.859, P =0.651). The binary logistic regression analysis showed that autoantibody did not have a regression relationship with sex, age, and type of injury (all P > 0.05) There were significant differences in prothrombin time activity (PTA) and international normalized ratio (INR) between the positive autoantibody group and the negative autoantibody group ( t =2.161, P =0.031; Z =-3.010, P =0.003). The ordinal logistic regression analysis showed that INR (odds ratio [ OR ]=3.101, P =0.040) and IgG ( OR =1.043, P =0.014) were associated with ANA grade. Conclusion There is a relatively high detection rate of autoantibodies in patients with DILI, and the detection rate of autoantibodies is not associated with sex, age, or type of injury. There are differences in PTA and INR between autoantibody-positive patients and autoantibody-negative patients, and the levels of INR and IgG are correlated with antibody titer.