OBJECTIVE To evaluate the relationship between the degree of nasal septum deviation and inferior turbinate hypertrophy with the CT. METHODS The paranasal sinus CTs of 98 cases with septum deviation were evaluated. Inferior turbinate on the deviated side of the nasal septum was considered as the control group and the inferior turbinate on the other side was taken as the study group in the same patient. The septal deviation angle, thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were measured. RESULTS The thickness of the bone, medial mucosa and lateral mucosa of the inferior turbinate were statistically different between the study group and the control group(P<0.05). There were statistically differences between the medial and lateral mucosal thickness in study group(P<0.05). There was no positive correlation between the deviation angle and the thickness bone, medial and lateral mucosa of the inferior turbinate in the study group(P>0.05), but the value of correlation coefficents revealed the inferior turbinate bone correlated with the deviation angle most, followed by medial and lateral mucosal thickness. CONCLUSION The hypertrophy of inferior turbinate in patients with nasal septum deviation is not only caused by mucosal hypertrophy, but also by hypertrophy of the inferior turbinate bone. The preoperative CT before septoplasty can be helpful to choose the surgical methods during the operation.

OBJECTIVE:To investigate the thoughts and ways of clinical pharmacist in nephrology department to review medi-cal orders,and to provide reference for rational drug use in nephrology department. METHODS:Based on specific cases of nephrolo-gy department,the thoughts and ways of clinical pharmacist in nephrology department to review medical orders were investigated from several aspects,including whether the therapeutic drugs had covered all the problems,drug duplication,drug selection,usage and dosage and course of treatments,drug interaction and compatibility. RESULTS & CONCLUSIONS:By establishing rigorous and systematic review thinking mode,based on their professional specialty,clinical pharmacists of nephrology department can sort the reviewing thought,fill in the gaps of medical orders reviewing and enhance the ability of participating in the clinical practice.

Objective To study the effect of letrozole (LE) on ovulation in patients with polycystic ovary syndrome (PCOS).Methods One hundred and sixty-four patients with PCOS were divided into LE treatment group (n=68) and chloramiphene (CC) treatment group (n=96).Growth rate of follicles,serum hormone level,endometrial thickness,and cervix mucus were observed before and after treatment.Results The growth rate of follicles was 1.67 and 1.78 mm/d,respectively,in LE and CC treatment groups (P=0.14).The serum T level on the day of LH peak was 2.1?1.9 and 2.0?1.7ng/dL,respectively,in LE and CC treatment groups (P=0.93).The serum testosterone (T) level on day of LH peak and on day 3 of menses was 2.1?1.9 and 1.4?1.5 ng/d,respectively,in LE and CC treatment groups (P=0.09).The serum E2 level on day of LH peak was 89.0?59.5 and 108.1?46.0 pg/ml,respectively,in LE and CC treatment groups (P=0.13).The endometrial thickness was 11.3?1.6 and 9.7?1.4 mm,respectively,in LE and CC treatment groups (P=0.07).The score of cervix mucus was 11.0?1.1 and 8.3?3.1,respectively,in LE and CC treatment groups (P=0.003).Conclusion Letrozole can effectively induce ovulation in patients with polycystic ovary syndrome,and does not increase serum T level.

Circulating microRNAs (miRNAs) is a class of non-coding small RNA molecules.As tumor biomarkers, circulating miRNAs deregulation is associated with the initiation and progression of human cancer.Studies indicate that circulating miRNAs have great potential in the early diagnosis and prognosis of primary or metastatic tumors (colorectal, breast, prostate, hepatocellular and ovarian cancer and other epithelial cancer).

Objective:To explore the hemodynamic effect of the modified Z Trendelenburg position in patients undergoing laparoscopic radical surgery of endometrial carcinoma, to provide a reference for the selection of the operative position of patients.Methods:A total of 80 patients who undergoing laparoscopic radical surgery of endometrial carcinoma from April 2017 to April 2019 in the Central Hospital of Xiangyang were recruited and assigned to experiment group and control group by random digits table method with 40 cases in each group. Patients in the experiment group were positioned in modified Z Trendelenburg position, while the patients in the control group were placed in conventional Trendelenburg position. The data of heart rate, mean arterial pressure, central venous pressure, systemic circulation resistance, cardiac output were recorded at 10 minutes before pneumoperitoneum (T 0), pneumoperitoneum immediately (T 1) and 5 minutes (T 2), 10 minutes (T 3), 30 minutes (T 4), 60 minutes (T 5) after pneumoperitoneum and 1 minute after recover horizontal position (T 6). Followed up investigation at 24 h after surgery, the degree of pain in the shoulder and the lower limbs were also recorded by Visual Analogue Scale(VAS). Results:The differences of heart rate, mean arterial pressure, systemic circulation resistance and cardiac output between the two groups had no statistical significance at T 0 to T 6 (all P>0.05). The central venous pressure were (9.86±1.95), (10.94±1.53), (11.33±2.24), (11.14±1.54),(7.75±1.59) cmH 2O(1 cmH 2O=0.098 kPa) respectively from T 2 to T 6 in the experiment group, lower than that of control group (18.83±2.82), (16.81±2.93), (16.27±3.56), (15.76±2.33), (8.92±1.68) cmH 2O at the same time, the differences were statically significant ( t values were 3.057-15.736, all P<0.05). The VAS scores of shoulder pain and low leg pain in experiment group were (3.48±1.10), (2.35±0.66) points, lower than that of control group (4.16±1.32), (2.99±1.02) points, the differences were statically significant ( t values were 2.404, 3.228, P<0.05). Conclusions:Modified Z Trendelenburg position can maintain the circulatory system hemodynamic stability, reduce the degree of shoulder pain and low leg pain after surgery in the laparoscopic radical resection for endometrial carcinoma patients.

Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in nasopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors.Methods:Eighty-two patients who received therapy due to cervical lymph node recurrence after deftnitive radiotherapy were reviewed.The relevant factors including sex.the interval between radiotherapy and recurrence,rN stage,recurrence site,treatment modalities,and treatment efficacy were analyzed.Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues,the number of positive nodes and surgical range.Kaplan-Meier method,Log-rank test and Cox method were used for statistical analysis.Results:The 1-,3-and 5-year local control rates were 58%,39.0%,and 39.0%,respectively.The 1-,3-and 5-year overall survival rates were 82.9%,47.6%.and 25.0%,respectively.The 1-,3-and 5-year overall survival rates in the radiotherapy-based treatment group were 80.8%,37.1%and 19.1%,respectively.The 1-,3-and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%,respectively.The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment.In the multivariate analysis,tumor recurrence site was an independent prognostic factor.Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after radiotherapy in nasopharyngeal carcinoma patients.

Objective · To determine the expression of miRNA-7 in TWEAK-stimulated macrophages and their secreted exosomes;to investigate the role of exosomal miRNA-7 from TWEAK-stimulated macrophages in modulating the metastasis of epithelial ovarian cancer (EOC) cells.Methods · Real-time PCR analysis was used to determine the miRNA-7 expression in TWEAK-stimulated macrophages,their exosomes and recipient HO8910-PM cells.The activity of EGFR signaling pathway in HO8910-PM cells was detected by Western blotting analysis.AntagomiR-7 was used to downregulate the miRNA-7expressions in macrophage exosomes and then their effect on metastasis of HO8910-PM cells was examined by transwell assay.Results ·TWEAK increased the levels of miRNA-7 in macrophages and their secreted exosomes and also resulted in an elevated level of miRNA-7 in recipient HO8910-PM cells,which eventually reduced the activity of EGFR/AKT/ERK1/2 pathway.Pre-transfection of antagomiR-7 remarkably decreased the levels of miRNA-7 in macrophages,their secreted exosomes and the recipient EOC cells,with the enhancement of HO8910-PM metastasis.Conclusion · Exosomal miRNA-7 from TWEAK-stimulated macrophages plays a critical role in suppressing the metastasis of EOC cells by attenuation of EGFR signaling pathway.

Pseudomonas aeruginosa. Ziying granule can protect the mice infected by colibacillus and staphylococcus aureus and increase animal survival rate. Conclusion Ziying granule has broad-bacteriostasis effect on common pathogenic bacteria in pelvic cavity.

Objective To evaluate the efficacy and safety of the InVance bulbourethral sling for stress urinary incontinence in male patients.Methods Five male patients with incontinence after prostatectomy were treated with the perineal sling(InVance).The patients aged from 62 to 76 years(mean,67 years),and the history of the incontinence ranged from 2 to 6 years(average 4 years).Four of the cases were due to TURP,and one radical prostatectomy.All the cases had been failed to respond to conservative therapies.Before the procedures,urodynamic examination showed a mean abdominal leak point pressures(ALPP)at 25.5 cm H2O(20-32.5 cm H2O).Under spinal anesthesia,a 3-to 5-cm vertical incision was made between the scrotum and the anus with the patients at the lithotomy position to expose the right and left ischiopubic branches.We put the three screws with its sutures on each bone and fixed the sling.A cough test was performed systematically and ALPP was set over 60 cm H2O.Results The operation time was 50-85 min(mean,60 min)and intraoperative blood loss was 20-50 ml(average 30 ml).The catheter was removed at day 5 and none of the patients had urination difficulty.The cases were followed up for 6 to 24 months(mean,12.6 months),during which urodynamic examination showed an ALPP at 65 cm H2O(55-70 cm H2O).Among the patients,the 4 who had received TURP were cured,and the other one undergone radical prostatectomy was improved.Conclusions InVance bulbourethral sling is suitable for mild-to-middle urinary incontinence after prostatectomy.

Objective To study effects of Kanglaite injection combined with gefitinib on inflammatory factors and immune function in patients with advanced lung cancer.Methods 98 patients with advanced lung cancer in First People 's Hospital of Yuhang District from December 2013 to September 2016 were selected and randomly divided into gefitinib-treated group and combination drug-treated group with 49 cases in each group.The patients in the gefitinib-treated group were treated with gefitinib, the patients in the combination drug-treated group were treated with gefitinib and Kanglaite injection.The clinical efficacy, inflammatory factors, immune function, quality of life and adverse reactions were observed and compared between the two groups. Results The efficacy and control rate in combination drug-treated group were higher than gefitinib-treated group(P<0.05).The inflammatory factors such as CRP, IL-6 and TNF-αwere significantly improved in the two groups before treatment, and the combination drug-treated group improved significantly better than gefitinib-treated group(P<0.05).The levels of cellular immune factors in the two groups were significantly improved compared with that before treatment, and the combination drug-treated group was significantly better than the gefitinib-treated group(P<0.05).The quality of life in the combination drug-treated group was significantly higher than the gefitinib-treated group(P<0.05).The incidence of adverse reactions such as nausea and vomiting, thrombocytopenia, and renal dysfunction in combination drug-treated group was lower than in the gefitinib-treated group( P<0.05).Conclusion Application of gefitinib combined with Kanglaite injection in the treatment of patients with advanced lung cancer treatment is more significant, can effectively reduce the systemic inflammation and adverse reactions, improve immune function and quality of life.