We present an extremely rare case of pleomorphic adenoma of the nasal septum in a 24-year old woman who went to consultation because of right nasal neoplasm. The radiologic discoveries by computerized tomography showed a tumor in the right nasal septum. Incisional biopsy was done, with a histopathological report of pleomorphic adenoma. Later, nasal endoscopy was used to remove the neoplasm and histology revealed pleomorphic adenoma of the nasal septum.
Adenoma, Pleomorphic ; diagnostic imaging ; surgery ; Catheter Ablation ; methods ; Cryotherapy ; methods ; Endoscopy ; Female ; Humans ; Nasal Septum ; diagnostic imaging ; surgery ; Nose Neoplasms ; diagnostic imaging ; surgery ; Rare Diseases ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Young Adult

Objective To investigate the application value of extracorporeal extended field radiotherapy in locally advanced cervical cancer. Methods A total of one hundred and twenty patients with stage IIB?IVA cervical cancer in the First Affiliated Hospital of Hebei North University from June 2012 to June 2014 were randomly divided into two groups:the control group and the observation group,each with 60 cases. The routine concurrent chemoradiotherapy was adopted in the control group. The observation group was treated with extracorporeal extended field radiotherapy combined with concurrent chemotherapy. The patients have been followed up for three years. The total efficacy rate,toxicity reaction,local progression free survival time ( PFS) and survival rate of the two groups were compared. Results The total efficacy rate in the observation group was significantly higher than that of the control group ( 88. 3%( 53/60 ) vs. 73. 3%( 44/60 ) , χ2 = 4. 357, P=0. 037),while the incidences of toxicity reaction in the two groups were 18. 3%(11/60) and 16. 7%(10/60), the difference was not statistically significant (χ2=0. 058,P=0. 810) ,the percentages of I and II degree in the two groups were 3. 4%( 2/60 ) and 3. 4%( 2/60 ) , the difference between the two groups was not statistically significant (Z=0. 000,P=1. 000). The PFS value in the observation group was significantly longer than that of the control group ( 25. 6 months vs. 13. 8 months,χ2 = 25. 624, P= 0. 000 ) , and the survival rate in the observation group improved significantly ( 53. 3%( 32/60 ) vs. 33. 3%( 20/60 ) , the difference was statistically significant (χ2 = 4. 887, P= 0. 027 ) . Conclusion Extracorporeal extended field radiotherapy is safe and effective in the treatment of locally advanced cervical cancer.

Objective To observe dynamically osteopontin(OPN) expression in the renal tubules of streptozotocin(STZ) induced diabetic rats, and to explore the relationship between OPN and angiotensinⅡ(AngⅡ), nuclear transcription factor-?B(NF-?B), and renal injuries. Methods Male SD rats were injected with STZ to induce diabetes mellitus, which were randomly divided into 5 groups and meanwhile there were other 5 age-matched normal control groups. Immunohistochemistry was employed to observe the expression of OPN, AngⅡ, NF-?B and fibronectin(FN) in renal tubules. The OPN and I-?B protein in renal cortex was detected by Western blot methods. Blood glucose, serum creatinine and 24 h urine protein were examined. The renal morphology was checked through light microscopy.Results The AngⅡand NF-?B expression from DM day 3, OPN expression from day7, FN from week 2 in renal cortex or tubules was increased as compared with control groups, while I-?B protein in renal cortex was gradually decreased since day 3. In DM week 4, there were positive correlations between OPN and AngⅡ, NF-?B, FN and 24 h urine protein. Conclusion An increase of OPN expression in the renal tubules of diabetic rats may be regulated by AngⅡ and NF-?B, and therefore participates the injury mechanisms of renal tubulo-intestitium.

Objective To explore the factors influencing serum trough concentration of vancomycin in pediatric patients with severe gram-positive cocci pneumonia. Methods The general information, the biochemical test results, and plasma concentration of vancomycin were collected from 93 pediatric patients with severe gram-positive cocci pneumonia. The relative factors influencing trough concentration of vancomycin were analyzed retrospectively. Results With the dosage of 40-60 mg/(kg·d), serum trough concentration of vancomycin were between 10-20 mg/L in 26 patients, <10 mg/L in 54 cases, ≥20 mg/L in 13 cases. The ALT, AST, GFR, and γ-GT were significantly different among three groups (P<0.05); the 10-20 mg/L group had the highest levels of AST and γ-GT, the ≥20 mg/L group had the highest level of ALT and the lowest level of GFR. Multiple linear regression analysis showed that GFR was negatively linearly correlated with the serum trough concentration of vancomycin (R2=0.039, P<0.05). The median serum trough concentration of vancomycin in pediatric patients with GFR≥90, 60–90, 30–60 mL/(min·1.73m2) were 8.66, 18.21, 8.45 mg/L respectively, and the difference is statistically significant (P<0.05). Conclusions The serum trough concentration of vancomycin is negatively linearly correlated with GFR in pediatric patients with severe gram-positive cocci pneumonia. The patients with impaired renal function are easier to reach the target serum trough concentration of vancomycin. Clinical use of vancomycin should follow the low doses in the range the guideline recommended, and the serum trough concentration should be closely monitored.

During the course of standardized residents training,the performance appraisal management of the residents was used besides other regular management methods.The allowances of residents were decided monthly by the evaluation and assessment of many kinds of tests or examinations.Through this new measure,the learning enthusiasm of residents could be fully motivated.The authoritative effectiveness of management was enhanced enormously.Meanwhile,the quality of the educational and training has also been improved greatly.This method could be very useful for the training process.

OBJECTIVETo explore action mechanism of electroacupuncture (EA) at "Fenglong" (ST 40) for treatment of hyperlipidemia.

METHODSForty SPF-grade SD rats were randomly divided into a normal group (group A), a model group (group B), a model diet-control group (group C), a model + EA group (group D) and model diet-control + EA group (group E), 8 cases in each one. The rats in group A were fed with normal diet continuously while those in the rest 4 groups were fed with high-fat diet to establish hyperlipidemia model. Afterwards, the rats in group C and group E were fed with normal diet, while EA at "Fenglong" (ST 40) was applied in group D and group E, 30 min per time, once a day. After 28 days of treatment, macrophage was collected in each group. Oil red O-staining was applied to detect the formation of foam cells, and enzyme-linked immunosorbent assay (ELISE) was adopted to measure the contents of total cholesterol (TC) in macrophage and analyze the rate of cholesterol efflux.

RESULTSThe counts of positive cells of oil red O-staining and the contents of TC in the group B, group C and group D were significantly increased compared with those in the group A (all P < 0.01). The counts of positive cells and contents of TC in the group C, group D and group E were significantly clecreased compared with those in the group B (all P < 0.01), and the decline in group D was more obvious than that in the group C (all P < 0.01). Compared with group C and group D, the counts of positive cells and contents of TC in the group E was obviously decreased (all P < 0.01), which was not statistically different from group A (P > 0.05). In the meantime, compared with group C, the rate of cholesterol efflux in group D and group E was significantly increased (both P < 0.01), and the rise in group E was more obvious than that in the group D.

CONCLUSIONThe electroacupuncture at "Fenglong" (ST 40) could significantly prohibit the transformation of macrophage into foam cell and increase rate of cholesterol efflux in macrophage, which could prevent and reverse the formation of foam cell and play an essential role in treating hyperlipidemia and stopping it from developing into a further level.

Acupuncture Points ; Animals ; Biological Transport ; Cells, Cultured ; Cholesterol ; metabolism ; Electroacupuncture ; Foam Cells ; metabolism ; Humans ; Hyperlipidemias ; metabolism ; therapy ; Macrophages ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley

Psychological suboptimal health status is an intermediate state between mental health and mental disease.Without timely intervention,psychological suboptimal health may develop into serious diseases that pose a threat to human physical and mental health,such as depression,anxiety disorders and high blood pressure.This review summarizes the scientific concepts,diagnostic Criteria,intervention and pharmacological research of psychological suboptimal health from the perspective of both modern medicine and traditional Chinese medicine and proposes possible solutions to existing problems in order to contribute to the identification,diagnosis,prevention and treatment of psychological suboptimal health.

Objective To analyze the relationship between collateral status and clinical manifestations or prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.Methods 181 patients with acute cerebral infarction in internal carotid arterial were selected.According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) standard,the degree of carotid stenosis was divided into 5 grades.All patients were divided into 3 subgroups according to the status of collateral circulation formation evaluated with the Regional Lepomeningeal Score(rLMC).The correlations were observed between the degree of carotid stenosis and the compensation level of collateral circulation,and the compensation level of collateral circulation and cerebral infarct volume,and the National Institute of Health Stroke Scale(NIHSS) on admission and the Activity of Daily Living(ADL) score at 3 months after stroke onset.Results The degree of carotid stenosis positively correlated with the compensation level of collateral circulation (r=0.724,P<0.01).The compensation level of collateral circulation negatively correlated with infarct volume (r=-0.313,P<0.01) and NIHSS score on admission (r=-0.504,P<0.01),but positively correlated with ADL score at 3 months after stroke onset (r=0.370,P<0.01).Diabetes was risk factor for the formation of moderate (OR=1.361,95%CI=1.145-1.902,P=0.029) collateral circulation,and hyperlipemia was risk factor for the establishment of moderate (OR=1.050,95%CI=1.011-1.219,P<0.01) or poor (OR=1.048,95%CI=1.010-1.225,P<0.01) collateral circulation.Conclusion The compensation level of collateral circulation positively correlates with the severity of carotid stenosis.Diabetes and Hyperlipemia are risk factors for the formation of collateral circulation.The improvement in the status of collateral circulation can significantly reduce infarct volume and improve prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.

Objective To investigate the influence of acupuncture on learning and memorial function and the expression of BDNF in prefrontal cortex of rats with sleep deprivation (SD), for providing theoretical evidence for treating sleep deprivation with acupuncture.Method Sixty Wistar rats were randomly divided into a control group, a model group, and an acupuncture group, 20 rats in each group. SD models were established by the modified multiple platform methods; the acupuncture group was intervened by acupuncture at Shenmen (HT 7); while the control group was left intact. Respectively after SD for 24 h and 72 h, the learning and memorial function was tested by using Morris water maze. Ten the rats were sacrificed to collect brain for detecting the expression of BDNF in prefrontal cortex via immunohistochemical method.Result The body weight, learning and memorial function, and the expression of BDNF in prefrontal cortex of the acupuncture group and model group were significantly different from those of the control group after SD for 24 h and 72 h (P<0.05). The learning and memorial function of the acupuncture group was significantly different from that of the model group after SD for 24 h and 72 h (P<0.05). The body weight and expression of BDNF in prefrontal cortex of the acupuncture group were significantly different from those of the model group after SD for 72 h (P<0.05).Conclusion Acupuncture can obviously improve the decline of the function of learning and memory of the SD rats, and also up-regulate the declined expression of BDNF in prefrontal cortex caused by SD.

Objective To provide anatomical basis for preventing paresthesia that appear in the lateral thoracic wall ,the arm‐pit and the inside of the upper arm during axillary lymph node dissection for breast cancer .Methods The intercostobrachial nerve (ICBN) and its contiguous relationship were observed ,besides the origin ,ramus and branch were measured and recorded by anato‐mizing 30 adult embalmed cadavers (60 sides) .Results Three intercostals nerve (50 sides) and the ICBN (29 sides) were the mainly nerves in lateral thoracic wall ,the medical brachial cutaneous nerve(MBCN) was not observed .Three intercostals nerve , ICBN(42 sides)and MBCN(44 sides) were found in armpit ,but mainly was intercostobrachial nerve (42 sides) .ICBN and the MB‐CN equally distributed in the dorsal and medical of the upper arm ,but the three intercostals nerve was not observed .81 .7% (49 sides) of intercostal nerve and all of the brachial plexus presenced filament .They existenced blood vessel accompanied when the ICBN pierced the chest wall (63 .3% ,38 sides) .Conclusion Identify and intactly preserve the ICBN and relevant nerves and their filament during axillary lymph node dissection of the breast cancer may benefit to prevent paresthesia .