Objective To summarize our experience in managing cerebrospinal fluid(CSF) rhinorrhea. Methods 82 cases of cerebrospinal fluid rhinorrhea treated in our department from 1995 to 1999 were reviewed retrospectively. 61 were male and 21 were female.They ranged from 2 to 82 years old.CSF leak was caused by trauma in 43 cases,iatrogenic injury in 18 cases and spontaneous leak occurred in 21 cases. Results 36 cases underwent surgical repair.The closure rate was 86 11%.Otorhinolaryngologists underwent 25 cases,and 23 cases succeeded (92%).The department of neurology underwent 11 cases,and 8 cases succeeded (72 7%). Conclusions The repair of CSF leak through transnasal extracranial approach can obtain better therapeutic results,especially through intranasal endoscopy.

Aged ; Bronchogenic Cyst ; complications ; Female ; Humans ; Infection ; complications ; Mediastinal Cyst ; complications

Animals ; Animals, Newborn ; Hippocampus ; metabolism ; Hypoxia, Brain ; metabolism ; Ischemic Preconditioning ; methods ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; metabolism

Objective To detect the tissue stiffness of liver lesions by using acoustic radiation force impulse imaging (ARFI) and to evaluate the clinical value on the characteristics of liver lesions.Methods ARFI was perforrned in 91 patients with 103 liver lesions (56 benign,48 malignant).Tbe elastographic images of virtual touch tissue imaging (VTI) and the values of virtual touch tissue quantification (VTQ) were analyzed.The area under the curve and cutoff value for VTQ value were used to assess diagnostic performance.Results On the elastographic images of VTI,79.17 ％ (31/55) malignant liver lesions and 56.36 ％ (38/48) benign liver lesions appeared stiffer compared with the surrounding liver parenchyma.There was statistical difference between malignant and benign liver lesions (x2 =0.627,P ＜ 0.01).The VTQ values of malignant and benign liver lesions were (2.64±0.65) m/s and (1.72±0.39) m/s,respectively,and there was statistical difference between them (t =8.638,P ＜ 0.01).With a cutoff value of 2.10 m/s for VTQ value,the sensitivity and specificity of diagnosis for liver malignancy were 83.3 ％ and 81.8 ％,respectively.Conclusion ARFI can provide information of the tissue stiffuess in live lesions,which is helpful in the differentiation between benign and malignant liver lesions and might become the imaging modality in the future.

Objective To investigate the application of high-frequency ultrasound in pre-operative evaluation of brachial artery elasticity in chronic renal failure patients planning arteriovenous fistula formation.Methods A total of 65 patients with chronic renal failure undergoing radial artery-cephalic vein fistula (chronic renal failure group) and 40 healthy adults (control group) were selected.The elastic modulus (EM) of brachial artery was calculated by ultrasound.All subjects were divided into 5 subgroups according to age (≥50 years),hypertension,diabetes and chronic glomerulonephritis.Patients in subgroup 0 (28 cases),subgroup 1 (22 cases),subgroup 2 (24 cases),subgroup 3 (20 cases),subgroup 4 (11 cases) had 0,1,2,3 and 4 risk factors respectively.Results The levels of systolic blood pressure,pulse pressure,serum creatinine,and the EM of brachial artery in chronic renal failure group were higher than those in control group:(20.65 ± 1.32) kPa vs.(16.38 ± 1.08) kPa,(8.64 ±0.51) kPa vs.(7.12 ±0.35) kPa,(637.3 ± 116.5) μ mol/L vs.(84.7 ±31.1) μmol/L,(132.96 ± 11.78) kPa vs.(102.16 ± 10.10) kPa,and there were significant differences (P ＜ 0.01 or ＜ 0.05).The single factor correlation analysis showed that age in control group,serum creatinine in chronic renal failure group and systolic blood pressure in two groups were significantly positively correlated with the EM of brachial artery(r =0.636,0.548,0.703; P ＜ 0.01).With the increase of risk factors,the EM of brachial artery increased gradually:(96.21 ±9.82),(104.45 ± 10.55),(114.87 ± 11.15),(127.26 ± 12.43),(143.54 ± 12.81) kPa in subgroup 0,subgroup 1,subgroup 2,subgroup 3,subgroup 4,and there were significant differences (F=17.43,P＜ 0.05).The EM of brachial artery increased significantly in subgroup 3 and 4 with multiple risk factors.Conclusions Brachial artery elasticity measured by high-frequency ultrasound can be used as an indicator of vascular function preoperative vascular assessment.Age,systolic blood pressure,pulse pressure and serum creatinine levels are the major risk factors for brachial artery elasticity.The coexistence of multiple risk factors of hypertension,diabetes or chronic nephritis could exacerbate the decrease of brachial artery elasticity.

Objective To study the characteristics of mesenchymal stem cells(MSCs)derived from chronic myelogenous leukemia(CML)patients' bone marrow and examine their hematopoiesis support in vitro.Methods MSCs from CML were obtained and cultured.Immunophenotype and in vitro differentiation capacities were investigated.Moreover,the Ph chromosome and bcr/abl gene of CML derived MSCs were detected.The expression of cytokines was detected by RT-PCR,and hema- topoiesis support of MSCs in vitro was detected by long-term bone marrow culture and the methylcel- lulose progenitor assay.Results CML derived MSCs showed a typical fibroblast like morphology. They were positive for CD29,CD44 and CD105,while negative for CD14,CD31,CD45,CD34 and HLA-DR.Under suitable conditions,CML derived MSCs could differentiate into osteoblasts and adi- pocytes.Further,CML derived MSCs showed a normal choromosome,and did not express bcr/abl gene.At last,they expressed hematopoiesis cytokines and possessed ability of hematopoiesis support in vitro.Conclusion There are MSCs with multidirectional differentiation potential in CML bone mar- row and they possess the ability of hematopoiesis support.

AIM:To compare the curative effect of conjoint fascial sheath suspension and the simple frontalis muscle suspension for moderate or severe ptosis.METHODS:In March 2013 to March 2016 in our hospital, 46 patients with moderately severe ptosis(68 eyes) were taken as the research objects.According to random number table method, they were divided into study group and the control group, 23 cases in each group.Study group(34 eyes) received the joint fascial sheath suspension (CFS), the control group(34 eyes) received frontalis muscle suspension.The degree of ptosis correction, upper eyelid retracted, satisfaction and complications of two groups were compared.RESULTS:The corrected rate of the treatment group was higher than that of the control group, the difference was statistically significant (P<0.05).After treatment, the upper eyelid retracted of the study group was significantly lower than that of the control group, the difference was statistically significant (P<0.05).The satisfaction of the treatment group was higher than that of the control group, the difference was statistically significant (P<0.05).The incidence of complications in the study group was significantly less than that in the control group, and the difference was statistically significant (P<0.05).CONCLUSION:Conjoint fascial sheath suspension is more effective on the treatment of severe ptosis than the simple frontalis muscle suspension, and has advantages such as less trauma, repeatable, and less complication.

AIM:To investigate the differences among Lenstar 900, A-scan ultrasound and keratometer in measurement of axial length ( AL ) , anterior chamber depth ( ACD ) and corneal curvature ( K1 , K2 , Km ) , and evaluate the consistency of the instruments, with the purpose providing references for the clinical application of Lenstar 900.
METHODS: In this study we picked up 36 patients ( 50 eyes ) underwent cataract surgery, and lens nucleus hardness were under level IV. Before the operation, AL, ACD and K1 , K2 , Km were measured by Lenstar 900, A-scan ultrasound and keratometer respectively. The differences between the results were compared by the paired t-test. The correlation of the results was analyzed by Pearson correlation analysis, and the consistency was measured by Bland-Ahamn method.
RESULTS: The mean AL and ACD values measured by Lenstar 900 and A-scan ultrasound had no significantly statistic differences (P>0. 05). The K1, K2, Km measured by Lenstar 900 and keratometer were not significantly statistical different (P>0. 05). The results measured by these three instruments had close linearity correlation ( r>0.9, P<0. 01). The consistency of the results was well in Bland-Ahamn analysis.
CONCLUSION:The preoperatively biometric result of Lenstar 900, A - scan ultrasound and keratometer in patients with cataract are all reliable, and they can be substituted by each other. However, Lenstar 900 can not only measure AL, ACD and corneal curvature at the same time, but also cornal thickness, lens thickness, white to white, pupil size, optical axis eccentricity, retinal thickness and so on. It has a number of advantages such as non-touching, convenient and efficient, and can be recommended to use widely.

Objective : To analyze the characteristics of HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou, and the influencing factors for new infection and local infection, so as to provide the evidence for AIDS prevention and control. Methods : From 2017 to 2019, the newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou were recruited, and their demographic information, previous sexual behaviors and history of HIV testing were collected in the questionnaire survey. The multivariate logistic regression model was used to analyze the influencing factors for new infections and local infections. Results : A total of 522 participants from 668 newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou during this period were surveyed．Among 522 cases, 263 ( 50.38% ) were aged 40 years or above, 218 ( 41.76% ) were married, 326 ( 62.45% ) had an educational level of junior high school or below, and 340 ( 65.13% ) were not local. Among 504 cases whose infection time could be determined, 72 ( 14.29% ) were newly infected within one year; age of 40 years below ( OR=4.148, 95%CI: 1.956-8.795 ), history of HIV testing ( OR=2.049, 95%CI: 1.163-3.609 ) and history of sexually transmitted diseases ( OR=2.169, 95%CI: 1.076-4.374 ) were risk factors for new infection. Among 454 cases whose infection location could be determined, 267 ( 58.81% ) were infected in Hangzhou; educational level of high school or below ( OR=2.538, 95%CI: 1.252-5.145 ) , Hangzhou residence ( OR=7.835, 95%CI: 4.227-14.353 ), living in Hangzhou for a year or over ( OR=18.960, 95%CI: 8.755-41.060 ) and monthly income of 3 000 yuan or over ( OR=2.630, 95%CI: 1.546-4.474 ) were risk factors for local infection. Conclusions The HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou are mainly floating population and less educated. The newly infected cases are more likely to be young and middle-aged people and patients with sexually transmitted diseases, the locally infected cases are more likely to be people with permanent residence, less educated and high income.

Genome-wide association study is an important approach to identify common genetic variants that predispose to human disease. Because of the high cost of genotyping on hundreds of thousands of markers on thousands of subjects, a more cost-effective two-stage case-control design is applied by most genome-wide association studies. To describe the design and statistical methods of the two-stage case-control study, this paper introduces the principles of two-stage case-control design, its implementing steps in genome-wide association study and the features of its application.The method is illustrated with an example.