Objective] To summarize the diagnosis and treatment of Professor Cai Wanru, famous Chinese medicine doctor of the state, the tutor of doctoral student in treating bronchial asthma. [Method] The author studies from the teacher, col ecting medical records, analyzing and learning the dialectical thinking and prescriptions of Professor Cai during treating bronchial asthma. [Results] According to the different stages of bronchial asthma, Professor Cai adopts the combination of differentiation and disease differentiation, uses Chinese medicine to treat bronchial asthma. We should clean lung and phlegm, smoothen breathing during exacerbation of asthma, invigorate the spleen and tonify the lung qi during remission of asthma, at the same time advocate treating winter disease in summer during consolidating period. In addition, clearing lung and regulating Qi should be used throughout al the course of disease. Professor Cai is good at using drug pairs and Chinese medicine flexibly, simply, effectively. [Conclusion] Professor Cai Wanru has been engaged in clinical respiratory department of internal medicine for a long time, having rich experience and unique insights on bronchial asthma, chronic cough, chronic obstructive pulmonary disease and other common respiratory system disease, worth learning.

OBJECTIVE: Study the clinical characteristics, treatment results and prognostic factors of hypopharyngeal carcinoma. MMETHOD: A retrospective analysis was performed of 97 hypopharyngeal cases that were treated in Department of Dtolaryngology of our hospital from January 2008 to December 2012. 93 cases of them are male patients, and 4 cases are female patients. The tumors are originated from pyriform sinus(75 cases), posterior pharyngeal wall (16 cases) and post-cricoid area (6 cases). Of the 97 patients,21 patients were treated with partial hypopharynx resection (21. 6%), 7 were treated with partial laryngectomy+ partial hypopharynx resection (7. 2%), 53 were treated with total laryngectomy+partial hypopharynx resection (54. 6%), 12 were treated with total laryngectomy and total hypopharynx resection, gastric-pharyngeal anastomosis (12. 4%) and 4 were treated with total laryngectomy and total hypopharynx resection, enteric-pharyngeal anastomosis (4. 1%). Sixty-one cases undergo postoperative radiotherapy in Oncology. Use Chi-square test to do enumeration data analysis, the survival rate is calculated with the life table method, survival analysis with Kaplan-Meier method, parallel Log-rank test. Cox regression multivariate analysis model is used to find the factors affecting prognosis. RESULT: The follow-up rate of this group was 90. 7%. All patients' 1-year survival rate is 76. 0% , 3-year survival rate is 56. 0%, pathological lymph node metastasis rate is 71. 1%, occult lymph node metastasis rate is 19. 6%. Local recurrence rate is 21. 6%. The main reasons of death in patients include : cervical lymph node metastasis in 7 patients (21. 9%), local recurrence in 12 cases (37. 5%), distant metastases in 10 patients (31. 3%) and so on. Univariate analysis showed that tumor size (P<0. 01) and tumor T stage (P<0. 05) have impact on survival prognosis, no risk factors was found with Cox regression multivariate analysis. CONCLUSION Hypopharyngeal carcinoma is difficult to be found early, prone to recurrence and metastasis after operation, carefully chosen surgical excision and neck dissection, adjuvant postoperative radiation therapy is the main treatment strategy. Posterior pharyngeal wall carcinoma tend to have higer recurrence and metastasis rate than the other two types of hypopharyngeal caocinom, and treatment would cause much larger injury, so more attention should be paid to this type of hypopharyngeal caocinom.
Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; surgery ; Hypopharynx ; surgery ; Laryngectomy ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Recurrence, Local ; Pharynx ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome

ve To understand the impacts of industrial fluoride-induced pollution on environment and human health. Methods The contents of fluorides in environmental media, such as air, soil, vegetables, weeds, branches and leaves in area around a certain chemical factory (polluted area) were monitored. The prevalance of dental fluorosis, the contents of fluorides in hair and nail were investigated among 87 individuals without history of exposure to industrial fluorides, living in polluted area for more than 5 years, and 132 individuals in control area. Results Higher fluoride levels in environmental medias, higher prevalance rates of dental fluorosis, high contents of fluorides in hair and nails of population were found in polluted area compared with those in control area. Conclusion The in-dustrial fluoride-induced pollution from this chemical factory had resulted in the hazardous impacts on environmental quality and human health.

The extraction method and structure of exo-polysoccharide from schizophyllum commune by submerged cultivation were studied. Proteins were removed com p letely from the polysoccharide by the sevag method following the isoelectric poi nt precipitation method. The purified schizophyllan was proved to be homogeneou s with molecular weight 4?10 4D by sephadex G-200 column chromatography, PAGE and HPLC. Its monomer was determined by hydrolysis, PC, GC and its structure wa s analyzed by IR, enzymolysis, periodate oxidation, the results showed that schi zophyllan was only composed of glucose and it was the ?-glucan consisting of ?-(1-3) and ?-(1-6) glucosidic linkages.

Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.

Objective To evaluate and analyse the morphological structure in late pregnancy women of pelvic hiatus by appli-cation of transvaginal three-dimensional ultrasound .Methods The 60 cases pregnant women who were checked pregnant weeks for 31 to 40 weeks from January 2012 to December 2014 came to our hospital were chosen as the observation group ,and other 60 cases women who were nulliparous women because of irregular menstruation at the same period treatment as control group .All patients underwent transvaginal three-dimensional ultrasound examination by observed the morphological structure of pelvic hiatus in each period ,and the research object of pelvic hiatus left and right diameter ,anteroposterior diameter and area were compared and meas-ured between the two groups .Results (1)The normal pelvic hiatus morphology was rhombic column crack-like structure ,but the observation group who had 43 .33% abnormal pelvic hiatus morphology and there was kind oval ;(2)The observation group were pelvic diaphragm hiatus of left and right diameter ,anteroposterior diameter and area were significantly larger than the control group in three conditions of the resting period ,anal contraction period and tension period ,and the difference was statistically significant(P< 0 .05) ;all the research object of the pelvic diaphragm hiatus left and right diameter ,anteroposterior diameter and area were de-crease in the anal contraction and increases in tension period for compared with the resting period ,so the difference was statistically significant (P< 0 .05) .Conclusion The three-dimensional ultrasound can be clearly observed the morphology of the female pelvic diaphragm hiatus ,and can be effectively evaluated .The late pregnancy women who will be significantly increases of pelvic dia-phragm ,occurs the relaxation phenomenon and some abnormal morphology for compared with nulliparous women .

Objective To explore the clinical features and endoscopic manifestations of eosinophilic gastroente-ritis(EG)in children.Methods A retrospective analysis was conducted of the clinical manifestation,laboratory examination,endoscopy(upper and/or colonoscopy)performance,diagnosis and treatment of 49 cases of patients who were diagnosed as EG in Children's Hospital of Nanjing Medical University from July 2013 to July 2015.Results The common clinical manifestations of EG in children were hematochezia(23 cases),diarrhea(20 cases),vomiting(18 cases)and abdominal pain(15 cases).The ages of children admitted to hospital for the first time ranged from 1 month and 7 days old to 13 years and 7 months old,and the mean age was 59.4 months old,in which most patients were younger than 1 year old,accounting for 38.77％(19 cases)of all.Peripheral blood eosinophilia was present in 20 cases(40.82％)of the patients,and only 6/18 cases(33.33％)of the patients had elevated serum IgE.Upon endoscopic analysis,the lesions involved esophagus(4 cases),stomach(14 cases),duodenum(20 cases),small intestine(15 cases),colon(28 cases)and rectum(6 cases),and the most common manifestation under gastroscopy was mucosal hyperemia edema(27 cases)and erosion(9 cases),while the most common manifestation under colonoscopy was mucosal hyperemia edema(25 cases)and nodular hyperplasia(24 cases).All patients improved with food restriction,in which 8 cases were treated with glucocorticoid while 9 cases with oral Singulair and 9 cases with oral Loratadine.All children with symptoms were alleviated somewhat,but 5 cases of them relapsed after drug withdrawal.Conclusions The clinical manifestations of EG in children varied and were mainly hematochezia,vomiting,diarrhea and abdominal pain.Some patients had the elevated peripheral blood eosinophilia and serum IgE.The most common manifestations under gastroscopy were mucosal hyperemia edema and erosion while the most common manifestations under colonoscopy were mucosal hyperemia edema and nodular hyperplasia.

Objective To investigate the effect of Rho GDP dissociation inhibitor 2 (RhoGDI2) and Bcl-2 in pathogenesis of hypoxic-ischemic brain damage (HIBD).Methods Neonatal 7-day-old Sprague Dawley rats were randomly divided into sham-operation control group,HIBD 6 h group and HIBD 48 h group (n =10 per group).The apoptosis rate of brain cell was measured by flow cytometer and the expression of RhoGDI2 mRNA and Bcl-2 mRNA were detected by Real-time RT-PCR.Results ( 1 ) The ligated cerebral hemisphere of neonatal rats showed obvious edema at 48 h after hypoxia-ischemia.( 2 ) Apoptotic cell appeared at 6 h in HIBD group,the apoptosis rate was ( 1.40 ± 0.12 ) ％.The apoptosis rate obviously increased to (15.86 ±0.98)％ at 48 h after HIBD,which showed a significant increase compared to sham-operation control group ( P ＜ 0.01 ).( 3 ) The expressions of both RhoGDI2 mRNA and Bcl-2 mRNA were 4.12 ±0.74 and 2.55 ± 0.65 respectively in sham-operation control group.In HIBD group,the expressions of both RhoGDI2 mRNA and Bcl-2 mRNA began to decrease at 6 h after HIBD ( 3.19 ± 0.77,1.96 ± 0.36) and decreased furthermore at 48 h after HIBD ( 1.04 ±0.18,1.06 ±0.17 ).The differences of expression levels among three groups were statistically significant (P ＜0.01 ).(4) The expression of RhoGDI2 mRNA positively correlated with the expression of Bcl-2 mRNA ( r =0.831,P ＜ 0.05 ).Conclusion With the emerging of apoptosis after HIBD,the expressions of both RhoGDI2 mRNA and Bcl-2 mRNA are decreased.The imbalance of expression of RhoGDI2 is involved in pathogenesis of HIBD by regulating Bcl-2 expression.

Objective To explore the value of evaluating rat liver fibrosis using contrast enhanced sonography.Methods Carbon tetrachloride was used to induce liver fibrosis.Under the mode of pulse-inversion harmonic imaging,ultrasound contrast agent was bolus iniected through tail vein,hepatic artery arrival time(HAAT),portal vein arrival time(PVAT),hepatic vein arrival time(HVAT)was recorded,and their relationship with immunohistochemical results were analyzed.Results There was no statistical difference of HAAT,PVAT between two groups among S0-S4 stage.HVAT was shorter in S3 and S4 stage than in S0-S2 stage(P＜0.05).HVAT was negative correlated with the percentage of immunohistochemical positive area of C-Ⅳ,LN,the correlation coefficients were-0.680 and -0.639 respectively.Conclusions Contrast enhanced sonography is useful for the diagnosing liver fibrosis.

Objective To investigate the effect and mechanism of phosphorylated protein kinase R-like ER kinase(p-PERK) and C/EBP homologous protein(CHOP) after hypoxic-ischemic brain damage ( HIBD) . Methods Neonatal 7-day-old Sprague Dawley rats were divided into sham-operation control group and HIBD group( n=30 per group) . Each group was divided into 0 h,6 h and 24 h subgroup after operation ( n=10 per group) . The ratio of apoptosis of brain cell was measured by flow cytometer and the expression of p-PERK and CHOP were detected by Western blot. Results (1)Apoptosis cell appeared at 6 h in HIBD group,the ratio of cell apoptosis was(2. 17 ± 0. 19)%. The apoptosis cell obvious increased at 24 h,the ratio of cell apoptosis was(13. 42 ± 0. 83)%. There was a significant increase in the ratio of apoptosis after HIBD 6 h and 24 h, as compared with sham-operation control group [ ( 0. 57 ± 0. 06 )%( P <0. 01 ) ] . ( 2 ) The expression of both p-PERK and CHOP was very low in sham-operation control group. In the HIBD group,the expression of both p-PERK and CHOP began to increase at 6 h and increased furthermore at HIBD 24 h. The differences in the expression levels of p-PERK and CHOP in HIBD group among different time points were significant( P<0. 01 ) . ( 3 ) The expression of p-PERK positively correlated with the expression of CHOP (r=0. 997,P< 0. 05). Conclusion With the emerging of apoptosis after HIBD,the expression of both p-PERK and CHOP increases. The imbalance in the expression of PERK induces the apoptosis of brain cells in the HIBD of neonatal rats by regulation of CHOP expression.