Objective:To Observe the effect of recombinant tissue-type plasminogen activator (rt-PA) in treatment of acute myocardial infarct.Methods:Two groups of patients were observed.The subjects in the control group (35 patients) were treated with routine intervention,while those in thrombolysis group (15 patients) were treated with rt-PA in addition to the routine intervention.Results:There is a better outcome in the thrombolysis group as compared with that in the control group,in terms of length of angina relief,degree and length of EKG changes as well as the time for serum enzyme changes.The mortality rate in the thrombolysis group was significantly lower than that in the control group (P＜0.01).Conclusion:The rt-PA for thrombolysis in acute myocardial infarct patients can reduce the infarct size and improve the cardiac function rapidly as well as increase the survival rate.

Objective To study the expression and clinical significance of thyroid transcription factor-1 (TTF-1) in stage Ⅰ non-small cell lung cancer (NSCLC) after operation and to 1 investigate the values in identification of the prognosis of stage Ⅰ NSCLC.Methods The expression of TTF-1 in 129 specimens of stage Ⅰ NSCLC was detected by immunohistochemistry.Results The positive rate of TTF-1 in stage Ⅰ NSCLC was 64.3％.There were significant differences in TTF-1 expression rate among pathological subtypes (x2 =25.231,P ＜ 0.001),different ages (x2 =4.581,P =0.032),sex (x2 =4.900,P =0.027) and differentiation degrees(x2 =11.519,P =0.019).Univariate analysis suggested that in the stage Ⅰ NSCLC patients,the median disease-free survival and overall survival of those positive for TTF-1 expression were superior to those negative:38.9 months versus 27.8 months (P =0.023) and 64.10 months versus 50.68months (P =0.013).Cox regression analysis suggested that TTF-1 expression,tumor differentiation degrees were independent factors affecting the prognosis of stage Ⅰ NSCLC.Conclusion Patients with TTF-1 positive expression often had better survival.Positive expression of TTF-1 and differentiation degree of tumor were independent prognostic factors to affect the prognosis of NSCLC.

Objective To evaluate the gene therapeutic effects of guinea pigs model with immune -mediated inner ear disease(IMIED)after locally injection of bone -marrow mesenchymal stem cells(BMSCs) decorated by in-terleukin-4 gene .Methods Guinea pigs were immunized with keyhole limpet hemocyanin (KLH) and caused 55 animal models ,divided into five groups ,each group with 11 animals :groupA(BMSCs carrier) ,group B(BMSCs emp-ty -carrier control group) ,group C(recombinent lentivirus IL -4 gene) ,group D(lentivirus empty -carrier control group) ,group E(simulation operation control group) .Groups were all injected with the corresponding suspension (20 μl)[includs BMSCs ceas of (1 .5~2 .0) × 106 ,the concentration of (entivirus) is 0 .5 × 108 pfu] by the scala tympani window into the inner ear .The fluorography immunohistochemistry test and enzyme immunohistochemistry test for the situation of IL -4 gene express and productive protein distribution in inner ear .Auditory functions and the KLH level of guinea pigs blood were monitored respectively by auditory brainstem responses (ABRs) and ELISA test .Results The threshold of ABR wave Ⅲ decreased in group A ,group B and group C .The result were more significant in group A and group B than that in group C ,but results in group A was more prominent (P<0 .05) . The results of immunohistochemistry test showed that fluorescence positive BMSCs mainly scattered in scala tymani and scala vestibule .The microscope results showed that for the group A ,B and C ,there were only few foccule and red and white blood cells in scala tympani floc ,but for group D and group E ,with different levels of labyrinthine hy-drops and some mononuclear cells around the spiral ganglion and small blood vessels .Conclusion Restructuring lentiviral vector with IL -4 gene can be successfully transfected into BMSCs in vitro ,compared to inplangting into inner ear in scala tympani approach ,the cells can migrate and generate gene product of IL -4 ,to significantly im-prove the auditory functions and inflammatory reaction of inner ear disease ,and BMSCs can be used as a carrier to migrate to the damaged part with therapeutic gene .

Objective To explore the establishment and evaluation of various forms of complementary transfer. Methods The former method using the traditional handover method, the establishment of various forms of complementary shift model improved, including optimized bedside handover, handover of patients′ bedsore image and emotional barometer over emotional changes, establish WeChat group to observe improvement;the first two months (99 cases, monitoring 42 days) and the improvement after the six months (97 cases, monitoring 43 days) score of nurses for the patient to grasp, bedside shift time and transfer the missing information. Concrete research and implementation methods, research objects, sample size, measurement indicators, evaluation methods, etc. Results Both shift mode, there is no information on patients admitted to general statistical difference (P>0.05);under complementary shift mode, nurse the patients′ condition from the master score (80.95 ± 4.30) points increased to (84.88 ± 4.01) points, in which the patients′condition data mastery score from (40.81 ± 2.02) points increased to (44.16 ± 2.88) points, nursing problems and measures of control points value from (13.21 ± 1.54) points increased to (14.44 ± 1.72) points, the difference was statistically significant (t =4.362, 6.209, 3.462, P<0.01);general information master score, treatment information at its disposal no difference scores statistically significant (P>0.05). Bedside nurse shift change time decreased from former improvements (31.21 ± 2.63) minutes to (14.42 ± 2.40) minutes, and the difference was statistically significant (t=30.767, P=0.000). Shift nurse missing information dropped from 16 times to 7 times, the difference was statistically significant (χ2=5.124, P=0.024). Conclusions Complementary model can reduce the insufficiency of current clinical succession work, help nurse master the patients′physical and mental conditions and more comprehensive understanding of the ward, reduce the omission or missing information and improve the working efficiency and responsibility.

OBJECTIVE: To assess the effect of one-stage repair of secondary nasolabial deformity and nasal septoplasty for cleft patients on nasal airway resistance (NAR). METHOD: Using active anterior rhinomanometry, NAR was measured in eighteen patients with cleft lip and palate who suffered form one-stage repair of secondary nasolabial deformity and septoplasty at per-and-post operation. RESULT: NAR was (0.664 +/- 0.200) kPa/(s x L) before operation, (0.304 +/- 0.180) kPa/(s x L) six months after operation, and (0.396 +/- 0.250) kPa/(s x L) twelve months after operation respectively. The differences are statistically significant (P < 0.01) between the NAR before and after operation. Subjective impression score of nasal patency was 7.5 +/- 1.5 before-operation, 2.1 +/- 2.0 after-operation for six months, 3.0 +/- 2.4 after-operation for twelve months. There are significant differences in the subjective impression score of nasal patency as well (P < 0.01). CONCLUSION Correction of septal deformities play a very important role in the operation for secondary nasolabial deformity, which can decrease NAR and improve the subjective impression of nasal patency.
Adolescent ; Airway Resistance ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Nasal Septum ; abnormalities ; surgery ; Nasopharynx ; surgery ; Postoperative Period ; Rhinoplasty ; Young Adult

OBJECTIVE: To explore the therapeutic methods and effect of pingyangmycin injection in huge hemangioma at Hypopharynx and laryngeal under suspension laryngoscopy. METHOD: To ananysize the medical records of 12 Patients with giant hemangioma at hypopharynx and laryngeal. Patients were underwent polysomnography before operation. Inseted the suspension laryngoscopy to pars laryngea by mouth to exposing the hemangioma under general anaesthesia, then injected Pingyangmycin by a long-tube needling (one time per three weeks, accumulated dose less than 50 mg). RESULT: Among all patients, ten were cured and two showed obvious improvement. The data of PSG after operation indicates that the symptom of anoxia of post-operation were significantly ameliorated than that of pre-operation, no recurrence occurred during one year follow-up of the hemangioma. CONCLUSION The methods of pingyangmycin injection under suspension laryngoscopic surgery is significantly enhanced clinical effect and improved the life quality of patients with huge hemangioma, which with low risk, high security, can ameliorating anoxia, complete cure, and is a ideal therapeutic measure.
Adult ; Bleomycin ; administration & dosage ; analogs & derivatives ; Female ; Hemangioma ; therapy ; Humans ; Hypopharynx ; pathology ; Laryngoscopy ; Larynx ; pathology ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the correlation between enhanced computed tomography (CT) findings and pathological results of rare parotid gland tumors, and improve diagnosis accuracy.

METHODSThe enhanced CT manifestations of 22 cases with pathologically documented rare parotid gland tumors, which included 6 cases of basal cell tumor, 5 cases of myoepithelioma, 4 cases of vascular invasion, 3 cases of lymphatic cyst, 3 cases of lipoma, and 1 case of chondrosarcoma, were retrospectively analyzed. The location, size, shape, density, and relationship with surrounding structure were evaluated on CT images.

RESULTSThe enhanced CT showed that basal cell tumors occurred in the superficial lobe of the parotid gland, with clear boundary, within the cystic lesion. The lesions were moderate to obviously enhanced, which may be accompanied by enlarged lymph nodes. Myoepithelial tumors were located in the superficial lobe of the parotid gland, with a small cystic prone and microcalcification within a few cases. The lesions were moderate to obviously enhanced. Hemangiomas of soft tissue mass prominent in the parotid gland surface were mild to significantly enhanced. Larger lesions may occupy the entire parotid gland, with uneven density and visible vein stone. The CT density values of the lymphatic cyst were usually higher. Chondrosarcoma mainly manifested cystic mass at the calcification edge. Lipoma with fat density mass exhibited clear boundary without enhancement. Fiber separation could be observed in the lesion.

CONCLUSIONCT can reflect the pathological features of rare parotid gland tumors by demonstrating their corresponding imaging features. Enhanced CT is the most effective means of imaging to identify the nature of rare tumor of the parotid gland lesions.

Objective To investigate the changes in angiopoietin 2 and endoplasmic reticulum stress,and the prognosis of acute phase of coronary syndrome (ACS) in type 2 diabetic patients with glycemic fluctuations.Methods Seventy-eight cases of consecutive diabetic patients with ACS within 7 days were enrolled.Another 78 cases of non-diabetic patients with ACS were selected as control.Risk assessment with global acute coronary events (GRACE) score in patients with ACS,dynamic blood glucose monitoring system (CGMS) for three days,realtime PCR analysis of angiopoietin-2,within the reticulum stress-related heavy chain binding protein (Bip),inositol kinase demand Ⅰ (IREI),endoplasmic reticulum class should PKR kinase (PERK),oxygen-regulated protein 150 (ORP150),activating transcription factor 6 (ATF6),X-box binding protein 1 (XBP1)mRNA expression change,phosphorylation of eukaryotic translation initiation factor 2oα (p-eIF2α) by western blotting angiopoietin-2,parameters were compared between the two groups.Correlation analysis with GRACE score ; while angiopoietin-2 parameters and glycemic fluctuation,endoplasmic reticulum stress-related genes correlation analysis were made.Results (1) ACS group average daily blood glucose fluctuations(MAGE),mean absolute difference daytime blood glucose (MODD),and postprandial blood glucose fluctuation (MPPGE) and the maximum amplitude of glycemic excursions (LAGE) were significantly higher [MAGE(5.13 ± 1.19) vs (3.19 ± 0.55) mmol/L,MODD (2.59 ± 0.72) vs (1.72 ± 0.63) mmol/L; MPPGE (3.51 ± 1.01) vs (2.58 ± 0.55) mmol/L and LAGE (7.75 ± 2.39) vs (4.34 ± 0.85) mmol/L,all P＜0.05].(2)In ACS group angiopoietin-2,endoplasmic reticulum associated genes Bip,IREI,PERK,ORP150,ATF6,XBP1,and monocyte chemoattractant protein 1 (MCP-1) mRNA expression levels as compared with the control group were statistically significant(all P＜0.05) ; Angiopoietin-2,protein p-eIF2α were higher(P＜0.05).(3) In the ACS group with pearson correlation analysis,angiopoietin-2 and MAGE,LAGE,MPPGE correlation (r =0.432,0.279,0.386,all P＜0.05),Bip and MAGE,LAGE,MPPGE correlation(r =0.783,0.589,0.887,all P＜ 0.05) ; IREI and MAGE,LAGE,MPPGE,MODD correlation (r =0.567,0.783,0.569,0.823,all P＜0.05) ; PERK and MAGE,MPPGE,MODD correlation(r =0.687,0.902,0.709,all P＜0.05) ; ORP150 and MAGE,LAGE,MPPGE,MODD correlation(r=0.779,0.871,0.775,0.689,all P＜0.05) ; ATF6 and MAGE,LAGE,MPPGE,MODD correlation(r =0.873,0.675,0.893,0.884,all P＜0.05),while XBP1 with no correlation with glycemic fluctuations (P＞0.05).(4) The endoplasmic reticulum stress gene was related to MCP-1 and blood glucose fluctuation parameters.(5) Multiple Logistic regression analysis revealed that LAGE,MPPGE,Bip,IREI,PERK,ORP150,ATF6 were risk factors affecting angiopoietin-2,and angiopoietin-2,ages,MAGE,homeostasis model assessment for insulin resistance,Bip,ATF6 were risk factors affecting GRACE.(6) The ejection fractions of the ACS patients showed negative correlation with MAGE and LAGE,multiple linear regression analysis showed that age,HOMA-IR,Ang-2,and MAGE,Bip,ATF6 established the linear regression relation with ejection fraction.Conclusion Glycemic fluctuations cause angiopoietin-2 to rise and lead to increased endoplasmic reticulum stress and affect the prognosis of diabetic patients with ACS.

Objective To perform facial nerve monitoring in patients under the low level of neuromuscular blockade during resection of acoustic neurinomas.Methods Twenty-eight patients with large,or medium acoustic neuroma underwent the surgery of acoustic neurinomas resection. During the operation,TOF and EEG monitoring were performed in order to detect the degree of muscle relaxation and the depth of anesthesia. Neuromuscular relaxation was maintained at T_4/T_1=25%～50% by adjusting doses of muscle relaxant and aneasthetic. Free-run EMG and Triggered EMG of orbicularis oris, orbicularis oculi, masseter and trapezius were recordered to monitor the function of the facial, trigeminal and accessory nerves, respectively. The function of the facial nerve was evaluated at first week and half year postoperatively according to House-brackmann classification.Results The facial never was successfully identified and mapped by neurominitoring in all 28 patients. successfully, tThe electrical stimulation was 0.1 mA-0.3 mA and no any involuntary body movement was observed in all patients ne of patients have moved during operation. The preservation of the facial nerve function following surgery was good. Five patients had a HB grade I, 13 a HB grade II, 8 a grade III and 2 a HB grade IV The facial nerve function was HB Grade Ⅰin 5 of 28 patients, HB GradeⅡ in 13, HB Grade Ⅲ in 8 and HB Grade Ⅳ in 2 immediately after operation. Six months after surgery, 10 casespatents showed demonstrated a HB GradeⅠof facial never function, 12 cases exhibited a slight palsy (HB Grade II) , and 5 cases exhibited a HB Grade III palsy and . Another 1 cases a exhibited severe palsy (HB Grade IV).Conclusions Facial nerve monitoring in patients under the low level of neuromuscular blockade can ensure the surgical safety and preserve the facial never function.