[ABSTRACT]OBJECTIVETo investigate malignant transformation of sinonasal inverted papilloma(SNIP) treated by endoscopic or endoscope assisted surgery, in order to analyze its probable prognostic factors and the optimized method.METHODSThe clinical data of 27 cases with malignant transformation of SNIP treated by endoscopic or endoscope assisted surgery from September 2001 to September 2010 were reviewed. According to preoperative imaging examination and UICC staging criteria, 3 cases were T1, 8 cases were T2, 12 cases were T3 and 4 cases were T4. 16 of them received radiotherapy after endoscopic surgery while the other 11 received surgery alone. RESULTSAll cases were confirmed as squamous cell carcinoma pathologically after surgery. The 5-year overall survival rate was 77.8% for all the patients. The 5-year survival rate was 75.0% for surgery alone group, of which 5 cases recurred locally after operation. The 5-year survival rate was 81.8% for surgery combined with radiotherapy group, of which 5 cases recurred locally and 2 cases died from intracranial metastasis.CONCLUSIONEndoscopic or endoscope assisted surgery can be used in the management of malignant transformation of SNIP to improve the quality of life, with the preponderances of desired effect and less complication. Application of radiotherapy after surgery could improve long-term survival rate of the patients.

[Summary] The article reported 107 cases of bile duct residual stones treated by plasma shock wave lithotripsy with inverse flush under fiber choledochoscope via T-tube fistula.Of the 107 patients, stones were completely removed in 98 patients, and residual stones remained in 9.Intraoperative biliary hemorrhage occurred in 5 cases, which were stopped after spraying the norepinephrine . There were 4 cases of arhythmia , 13 cases of subcostal or upper abdominal pain , and 11 cases of abdominal distention and diarrhea , all of which were cured by symptomatic treatment .Postoperative biliary infection occurred in 7 cases, which were cured by anti-infection and biliary drainage.Except for 1 patient of lost of follow-up, 106 patients were followed for 6 months.Ultrasound and CT examinations showed free of calculus in 101 cases, and intrahepatic bile duct residual stones in 5 cases.We deem that plasma shock wave lithotripsy combined with reverse flushing under fiber choledochoscope is a minimally invasive , safe, and effective treatment for difficult biliary residual stones .

We present a rare case report of foreign body of the nasal apex in a 22-year man who were hospitalized because of a bit of metal rebounded. There was slight bleeding at wound site with a feeling of pain and swelling. On physical examination, the apex lied in the median position with a bleeding cut about 3 millimeter in length. There was no visible stump on the cut or rupture in the nasal vestibular. Computed tomographic scan showed the abnormal high-density shadow in the nasal apex while the foreign body was located in the subcutaneous tissue of the antero-upper part of septal cartilage. The admitting diagnosis was foreign body in nasal apex. Endoscopic surgery was adopted to remove the foreign body.
Endoscopy ; Foreign Bodies ; surgery ; Humans ; Male ; Metals ; Nasal Cartilages ; pathology ; Nasal Cavity ; surgery ; Pain ; Subcutaneous Tissue ; pathology ; Young Adult

OBJECTIVE: To summarize the clinical characteristics and treatments of patients with malignant transformation of sinonasal inverted papilloma (SNIP), and to explore the factors influencing the prognosis of malignant SNIP. METHOD: To retrospectively analyze the clinical data of 35 patients with malignant SNIP. The prognosis affected by age, gender, pathogenetic locations, pathology, clinical stages and treatments were analysed using Kaplan Meier, Log rank and Cox method. RESULT: In our research, 5 years survival rate was 68.6% in malignant SNIP. There were 3 factors effecting the 5 years survival rate of malignant SNIP: clinical staging, histopathological features and treatments while gender, age, disease location, and percentage of the malignant cell in the entire tumor tissue had no effect on overall survival rate. Clinical staging and treatment were the independent factors that influenced the prognosis of malignant SNIP (P value was 0.019 and 0.006). CONCLUSION Risk factors that independently influence the survival of patients with malignant SNIP were the clinical staging and treatment. The degree of histo pathological features can be the secondary indicator to judge the prognosis of malignant SNIP. Endoscopic surgery or comprehensive therapy performed on patients properly is therapeutically effective.
Cell Transformation, Neoplastic ; Endoscopy ; Humans ; Nose Neoplasms ; diagnosis ; pathology ; Papilloma, Inverted ; diagnosis ; pathology ; Prognosis ; Retrospective Studies ; Survival Rate

Objective To assess the left ventricular global systolic function changes using ultrasonic three -dimensional speckle tracking imaging (3 D -STI )in patients with uremia undergoing high -flux hemodialysis (HFHD)treatment.Methods 86 patients with uremia and 59 healthy volunteers were selected.Participants of control group underwent plasma brain natrinuretic peptide(BNP)examinations before 3D -STI examinations.All the uremia patients received HFHD therapy,and underwent BNP and 3D -STI examinations before and after 4 weeks HFHD therapy.Parameters of left ventricular three dimensional global area strain(GAS),global circumferential strain (GCS),global longitudinal strain(GLS)and global radial strain(GRS)were measured in each group.The correlation between each 3D -STI parameters and BNP level were analyzed.Results Compared with the control group,GAS, GCS,GLS and GRS of left ventricular were significantly lower(t =7.564,6.866,7.946,5.477,all P <0.05)and BNP level in the control group were significantly higher in the uremia group[(60.75 ±17.22)ng/L vs.(792.68 ± 184.56)ng/L,t =30.876,P <0.05].After HFHD therapy 4 weeks,GAS,GCS,GLS and GRS of left ventricular were significantly higher(t =4.233,5.933,6.546,2.959,all P <0.05)and BNP level were lower(t =27.533,P <0.05) than before treatment in the uremia group.GAS,GCS,GLS and GRS of left ventricular were negatively correlated with BNP level(r =-0.51,0.64,-0.46,-0.43,all P <0.05).Conclusion 3D -STI can accurately evaluate the changes of left ventricular global systolic function in patients with uremia before and after hemodialysis,and provide reliable basis for clinical treatment and efficacy assessment.

Objective To examine the expression of lipoxygenases (LOXs)on human pancreatic carcinoma and their effects on proliferation and apoptosis of human pancreatic carcinoma in vitro.Methods Expression of 5- LOX and 12-LOX in the tissue of human pancreatic carcinoma and pancreatic cancer cell line (SW1990) was detected by immunohistochemical staining and RT-PCR.To examine the effects of polyunsaturated fatty acids on pancreatic cancer cell line,the proliferation rate of SW1990 cells treated with arachidouic acid (AA),docosahexaenoic acid (DHA) and eicosapentenoic acid (EPA) was analyzed by MTT and the incorporation of bromodeoxyuridine (BrdU) methods.An annexinV/propidium iodide (PI) assay with flow cytometry and in situ terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin end labeling (TUNEL) assay were used to identify potential induction of apoptosis by the unsaturated fatty acids.The effects of 5-LOX inhibitor (MK-886) and 12-LOX inhibitor (baicalein) on the proliferation of SW1990 cells were determined by above methods.Results Both 5-LOX and 12-LOX were over expressed in the tissue of human pancreatic carcinoma and the pancreatic cancer cell line.AA had a stimulatory effect on the growth of SW1990 cells while EPA and DHA had an inhibitory effect in a dose-dependent manner.The apeptosis of SW1990 cells co-cultured with DHA or EPA lasting for 24 hours was increased markedly.Furthermore, both MK-886 and baicalein in a dose-dependent-manner inhibited the growth of SW1990 cells ard induced a significant increase of apoptotic cells rate.Conclusions Expression of lipoxygenase is up-regulated in human pancreatic cancer. Polyunsaturated fatty acids have regulatory effects on the growth of pancreatic carcinoma in vitro.AA stimulates proliferation of pancreatic cancer cell line,while DHA and EPA suppress proliferation,simultaneously inducing apoptosis of pancreatic cancer cell line.Blocking the functions of lipoxygenase with its inhibitor exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro.Lipoxygenase might be a novel therapeutic target for the pancreatic cancer.

Objective In order to improve the surgical treatment for midpiece esophageal carcinoma, different surgical ways were com-pared. Methods From January 2010 to June 2012, 110 patients with midpiece esophageal cancer in our hospital were divided into the Ivor-Lewis group (55 cases) and the Sweet group (55 cases) according to different surgical ways, that is to say Ivor-Lewis surgery via right chest and Sweet surgery through left chest. Length of specimens, rang of tumor invasion, distance of removal, incidence of residual carcinoma in the esophageal edges, number of lymph nodes removed in chest and abdomen, and positive rate of carcinoma infiltrated lymph nodes were compared between the two groups. Questions of surgical anatomy were investigated through questionnaire among surgeons of the two groups, and the scores of both groups were analysed. Results The length of resected specimens and number of lymph nodes removed in Ivor-Lewis group was significantly lager than that of the Sweet group (P<0. 01). The positive rate of carcinoma infiltrated lymph nodes in Ivor-Lewis group was 1. 82%, which was significantly lower than 21. 82% in the Sweet group (P<0. 01). Results of questionnaire showed surgeons have gieven higher scores to Ivor-Lewis group. Conclusion Ivor-Lewis surgery is recommend for upper and midpiece esophageal carcinoma while Sweet surgery is more suitable for cardial and lower esophageal cancer.

Objective:To explore the relationship among blood glucose,blood lipid levels,peripheral blood white cells and slow coronary flow (SCF).Methods:Clinical data of 183 patients receiving angiography in our hospital from Apr 2010 to Apr 2013 were retrospectively analyzed.Patients with TIMI grade 2 or lower coronary blood flow were defined as SCF;patients were divided into SCF group (n=93)and normal control group (n=90).Levels of blood lipid,glycosylated haemoglobin (HbA1c),hematocrit,and peripheral blood white cell levels were measured and compared between two groups.Results:Compared with normal control group,there was significant reduction in high density lipoprotein cholesterol (HDL-C) level [(1.21 ± 0.26)mmol/L vs.(1.12 ± 0.28)mmol/L,P =0.043],and significant rise in HbA1c level [(5.41±0.50)% vs.(5.83±0.45)%,P =0.01],hematocrit [(0.41 ±0.04)vs.(0.43±0.07),P =0.01]and white blood cell count [(6.1±1.6)109/L vs.(6.7±1.7)109/L,P <0.05]in SCF group.Logistic analysis indicated that white cell count was the risk factor of SCF (OR 1.920,95% CI 1.234~2.987,P =0.004).Conclusion:Levels of high density lipoprotein cholesterol,glycosylated haemoglobin, hematocrit and white blood cell count are related to slow coronary flow,and elevated white blood cell count may be a risk factor aggravating slow coronary slow.

ObjectiveTo evaluate the effectiveness of correction of posttraumatic flexion contracture of knee(FCK) using Ilizarov technique.MethodsSix male patients with posttraumatic FCK,aging from 9 to 43 years(mean,24.5 years),treated by using Ilizarov technique from January 2006 to December 2010,were retrospectively analyzed.The preoperative flexion deformity of knee ranged from 35° to 85° (mean,47.6°),and the range of motion ranged from 0° to 70° (mean,15.8°).Among them,five patients had old fracture of knee joint combined with equinus foot deformity (deformity ranging from 25° to 37°,with an average of 31.8°); one patient had femoral supracondylar fracture.We used circular external fixator to correct the FCK and equinus foot deformity gradually,the knee arthrodesis operation was performed in 4 patients because of the damaged hone structure and poor soft tissue condition.ResultsAll patients were followed up for 12-22 months(mean,18 months).The flexion of knee joint was recoverd from preoperative 47.67°±18.63° to postoperative 9.33°±3.50°.Plantar flexion of ankle joint in five equinus foot deformity was recovered from preoperative 31.80°±4.65° to postoperative 3.00°±4.47°.The kuee joint was arthrodesised successfully in 4 patients and the other 2 patients got 30° and 75° ROM.All the patients can walk with a cane,and satisfied with the result of treatment.Pin-site infection was found in 4 patients and was controlled within two weeks.ConclusionIlizarov technique is an effective treatment method for posttraumatic FCK.Knee arthrodesis should be performed when patients had damaged bone structure and poor soft tissue condition.

Objective To investigate the changes of hematoma and perihematomal edema in spontaneous hypertensive rats (SHRs),as well as the correlation between blood pressures and perihematomal edemaMethods A total of 24 6-month-old male SHRs were included.They were randomly divided into intracerebral hemorrhage 1-,3-,5-,and 7-day groups (n =6 in each group).Blood pressure was determined by tail-cuff sphygmomanometry.Collagenase Ⅳ was injected into caudate nucleus in order to induce a model of intracerebral hemorrhage.Magnetic resonance T2 weighted imaging was used to observe hematoma and perihematomal edema.Results On day 1 after modeling,the blood pressure was decreased significantly compared to that before modeling,and it was elevated gradually on day 3.Parallel profile test showed that the overall profile was parallel between the change rate of blood pressure and the change rate of perihematomal edema volume (F =2.820,P =0.063).The coincident profile test showed that both the overall profiles did not coincide (F =10.961,P =0.000).The change rate of systolic blood pressure was significantly positively correlated with the change rate of perihematomal edema volume (r =0.527,P =0.024) and the change rate of perihematomal edema volume (r =0.755,P =0.000) showed a significant positive correlation.Conclusions Brain edema appeared and expanded rapidly on the day of intracerebral hemorrhage in SHRs.It reached the peak on day 3,and then dissipated gradually.The blood pressure decreased significantly on day 1 after intracerebral hemorrhage,and it began to increase from day 3 till day 7.The changing trends of the blood pressure and perihematomal edema volume were parallel to each other,and the change rate of systolic blood pressure and the change rate of perihematomal edema volume showed a positive correlation.