Objective To establish a method for recognizing nasal bleeding sites and hemorrhagic foci of hidden epistaxis.Methods The bleeding sites and hemorrhagic foci,as well as the used surgical techniques and the curative effects were studied retrospectively in 122 patients with spistaxis from Jan.2005 to Oct.2007,in whom the bleeding sites and hemorrhagic foci were not found by routine nasoscope examination.Under nasal endoscopic monitoring,electric heat cauterization(EHC),microwave coagulation(MC) and micro-traumatic nasal packing(MTNP) were applied respectively to treat the hidden epistaxis.Results The hemorrhagic foci were found in the following sites:Olfactory cleft 48 cases(39.3%),superior wall of inferior nasal meatus 20 cases(16.4%),posteroinferior wall of middle nasal meatus 6 cases(4.9%) and so on.Epistaxis was well controlled in 113 of 122 cases(92.6%),in whom the hemorrhagic foci were found by endoscope,by laser soldering,MC and EHC.Packing with mini gel foam was used in 9 cases,for whom the hemorrhagic foci were not found.No complications occurred during a 1-2 months of follow up after treatment.Of the 122 cases,106 cases(86.9%) stopped bleeding by treatment once and 16 cases(13.1%) stopped by treatment twice.Conclusion The lateral or posterior area of middle and inferior nasal meatus,and olfactory cleft area are the frequent sites of hidden epistaxis.Examination with endoscopy,combined with the findings on the middle and inferior turbinate and the features of blood flow in different sites,will be important on recognizing the hidden epistaxis and locating the hemorrhagic foci.

Objective To investigate the pathogenesis,diagnosis and therapy of intranasal contact point headache.Method The clinical data of 73 patients with contact point headache between the septum and the lateral nasal wall were retrospectively reviewed and the anatomical abnormality of nasal carity was determined by CT scanning of the sinuses and endoscopy.All the patients underwent surgical intervention for correcting the abnormal anatomical conditions of nasal cavity.Results The headache disappeared in 67 of the 73 patients after topical anesthesia,and in the 6 remainders after maxillary sinus puncture.Among the anatomic variations in all the cases,endoscopy revealed that 31 sides there was hypertrophy of ethmoidal bulla,hypertrophy and medial deriation of processus uncinatus in 59 cases,abnormality of middle turbinate in 91 sides,and upper nasal septal deviation in 51 cases.Among the 73 cases,there was confact of two or mose sites of mucosa of the abnormalities in 57 cases.The headache disappeared in 64 patients(87.7%) one week after operation,and it was reduced in 9 cases(12.3%).12-month follow-up showed recovery in 59 cases(80.8%),in 12 cases(16.4%) it was partially relieved,and in 2 cases(2.7%) there was no effect.Conclusions Abnormal nasal septa,enlarged turbinates and other anatomic abnormalities are the most common findings in contact point headache.Pressure due to mucosal contact between the septum and lateral nasal wall mucosa,and maxillary sinus orifice occlusion are the major causes of contact point headaches.Endoscopy,CT scanning,and topical anesthesia are ideal in diagnosis of intranasal contact point headache.

Objective To observe the effect of elbow support on muscle activity and subjective feelings of comfort during typing.Methods Ten college students voluntarily participated in this experiment.They typed the same text using elbow supports of five different heights.The distance between their elbows and the desk was supported at 3 cm below,0 cm,and-3 cm and-6 cm above the desk.There was also an unsupported condition.Myoelectric readings were recorded from the right splenius,trapezius,biceps,extensor carpi radialis,flexor digitorum superficialis,flexor carpi radialis,and extensor digitorum muscles.Perceptions of comfort of the neck,shoulder,hand and forearm,and hand using the different supports were surveyed using a questionnaire.Results One way ANOVA shows that the height of the elbow significantly affects the activity of the trapezius,the extensor carpi radialis and the extensor digitorum muscles.Trapezius muscle activity was higher with 3 cm high elbow support than without support,and the value was smaller when using-6 cm elbow support.The activity of the carpi radialis longus extensor was least when using-6 cm and-3 cm elbow support,and greatest with 3 cm support.Extensor digitorum activity was least when using-3 cm high elbow support and again greatest with 3 cm support.The different elbow support heights had no significant relationship with comfort perceptions for any body part.Conclusion The height of elbow support can change the average myoelectric signals from muscles during typing,but there is no significant difference in the typist's perception of comfort.This could be due to a change of typing position and neuromuscular motion control mode in response to the height of elbow support.

Objective To discuss endoscopic surgical treatment and its effect of intranasal contact point headaches.Methods Twe(n)ty-five patients with intranasal contact point headaches were treated by endoscopic rhinoplasty of nasal cavity,including middle turbinoplasty,functional resection of ostiomeatal complex,endoscopic submucous septoplasty.Achieved organic combination of the above surgery methods according to the different results of the CT scan and endoscope,the surgical procedure waft designed individually.Results All patients were followed up for 9 to 12 months.Recovery was 21 cases(84.00%),efficacy was 3 cases(12.00%),inefficacy was 1 case(4.00%),the rate of fully recovered without serious complication was 96.00%(24/25).Conclusions Intranagal contact point headaches is a sort of the nasal headaches as a result of multi abnormality of nasal cavity structure.Endoscopic rhinoplagty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.

Objectve To detect whether the CTP(phosphocholine cytidylyltransferase) gene was expressed in the asexual erythrocytic stages of Plasmodium falciparum (FCC 1/HN )by using the RT - PCR and to construct eukaryotic expression vector of CTP. Method The erythrocytic stage parasites of Plasmodium falciparum were cultured as described by Trager and Jensen. RNA from erythrocytic stage parasite was extracted by using Trizol reagent. The complete genes coding for CTP gene isolates FCCI/HN were amplified by reverse transcriptase -polymerase chain reaction(RT- PCR). CTP gene was cloned into eukaryotic expression vector pcDNA3. Results CTP encoding gene was amplified from the erythrocytic stages of Plasmodiumfalciparum (FCC 1/HN) and eukaryotic expression vector of CTP was constructed. Conclusion CTP gene was expressed in the erythrocytic stages of Plasmodium falciparum (FCC 1/HN) and eukaryotic expression vector of CTP was successfully constructed.

Objective This study aimed to evaluate the reliability of Tslew in survelliance of allograft rejection after heart transplantations in rats. Methods Forty rats underwent modified Ono's heterotopic heart transplantation. The autonomous IMEG and VER were recorded with epicardiac pacing leads fixed at right ventricular outflow tracts, left ventricular apex and free wall. Tslews were detected daily in these 10 syngeneic and 30 allogeneic transplants. Syngeneic transplants were sacrificed on 7th postoperative day and allogeneic transplants were sacrificed on 3rd, 5th and 7th postoperative days, respectively.Histopathologic studies were performed at the same time. Results On the 3rd ,5th and 7th postoperative days Tslews depressed gradually in the allogeneic group. The depressions between 3rd and 5th, 3rd and 7th were obvious( P ＜0.05 ). No significant differences were observed in the syngeneic group. Tslews differed between the two groups at 5th and 7th postoperative days ( P ＜0.05 ). The Depression correlated with histopathologic results. Area under ROC( receiver operating characteristic) curve (AUC) of Tslew was 0.9474 and the 95% confidence interval(CI) was (0. 8753 -1. 0000 ). At the cutoff point of 92% ( ≤92% considered positive), Tslew had a sensitivity (Se) 100%, specificity (Sp) 63.64%, positive predictive value (PV + )82.61%, negative predictive value (PV-) 100%, respectively. At the cutoff point 85%, Sp 90.91%, Se 78.95%, PV +93.75 %, PV- 71. 43%. At the best cutoff point 90%, Tslew had a Se 94.74%, Sp 81. 82%, PV + 82.61%, PV- 90%.Whereas QRS had a Se 68.42%, Sp 90.91%, PV + 92.86%, PV- 62.50% at the best cutoff point of 72.3%. Conclusion Tslew of VER are reliable indexs to monitor acute allograft rejection after heart transplantations in rats. Having great diagnostic value, Tslew may be used as a replacement for EMB at the best cutoff point when EMB can' t be performed. At cutoff point of 92%, Tslew may be used as a screening index.

Objective To investigate the reliability of intramyocardial electrogram (IMEG) in monitoring acute rejection after human heart transplantation. Methods From June 2004 to March 2009, 32 patients underwent orthotopic heart transplantations. During the operation telemetric pacemakers were placed under the skin of the body with connected bipolar electrodes implanted into epimyocardium. Postoperative IMEGs, including the autonomous IMEG and ventricular evoked response (VER) were recorded routinely. The endomyocardium biopsy (EMB) was taken routinely and performed once again when positive IMEG results or other positive signs were observed. Results Totally 523 IMEGs has been produced, 41 of VERs were recorded together with autonomous IMEGs and EMBs, in which 17 EMB specimens were confirmed positive and 24 negative. AUC of QRS was 0.7537, Se was 88.24%, Sp was 62. 50%; AUC of Tslew was 0. 9081, Se was 94. 12%, Sp was 87. 50%. QRS and Tslew had significant difference in AUC of ROC, with x2 = 4. 22, P＜0. 05; AUC of combined diagnostic index (positive when either QRS or Tslew is positive and negative when both values are negative) was 0. 7917, Se was 100.00%, Sp was 58. 33%. Conclusion QRS amplitude of the autonomous IMEGs, Tslew of VERs and combined diagnostic index are reliable indexes for monitoring acute allograft rejection after human heart transplantation. Furthermore, Tslew has a better prognostic value than QRS.

Objective To prepare melanoma antigen n(MAGEn)protein vaccine and to investigate the immune responses and anti-tumor effects of MAGE-n protein vaccine accompanied by CpG-containing oligodeoxynucleotide(CpG-ODN)adjuvant.Methods The DH5? containing the MAGE-n prokaryotic expression plasmid pGEX-MAGE-n was induced and the protein was purified as protein vaccine.The CpG-ODN was synthesized as adjuvant and the C57BL/6 mice were inoculated.The cellular and humoral immune responses were detected by ELISPOT,cytotoxicity assay and enzyme linked immunosorbent assay(ELISA).The antitumor effects were detected through tumor volume and life span.Results The MAGE-n protein accompanied by CpG-ODN could induce strong MAGE-n-specific cellular and humoral immune responses.In the MAGE-n positive B16 tumor model of C57BL/6,the growth velocity of tumor was decreased and the life span was prolonged with the treatment of vaccine.Conclusion MAGE-n protein vaccine accompanied by CpG-ODN adjuvant can induce strong immune responses and anti-tumor effects against MAGE-n positive B16 tumor,which provides a new way for tumor therapy.

Objective To observe the effect of different explosion impulse on rabbit lung injury and decide the death curve,so as to provide a reference for the prediction of lung injury.Methods Six healthy male New Zealand white rabbits with weight of 2.0-2.5 kg and age of (6 ± 1)months were selected.The rabbits were put 0.5 m,0.6 m,0.7 m,0.9 m,1.0 m,and 1.2 m away from 90 g TNT to carry out the blast injury experiment.The characteristic parameters of blast shock wave and general lung injury were recorded.Based on the experimental results combined with theoretical analysis,the changes of rabbit lung injury depending on the explosion distance as well as the rabbit death curve were determined.Results After the 90 g TNT explosion,the peak overpressure of shock wave and the corresponding specific impulse decreased quickly with the increase of explosion distance.The peak overpressure was 0.79 MPa and the specific impulse was 82 Pa · s at the explosion distance of 0.5 m.The peak overpressure was 0.1 MPa and the specific impulse was 34 Pa · s at the explosion distance of 1.2 m.The rabbits at 0.5 m and 0.6 m died,the rabbit at 0.7 m was severely injured,and the rabbits at 0.9 m,1.0 m,and 1.2 m were slightly injured.The dependence of lung injury degree on the explosion distance under 90 g TNT explosion was established based on dimensional analysis theory.The lung injury degree was exponentially attenuated with the explosion distance:φ =(R/0.6)-5.64(φ represented lung injury degree,and R represented the explosion distance).Considering the combined injury effects of peak overpressure of shock wave and its specific impulse on rabbit lung,the death curve of rabbit was determined:(p-0.1) (I-59) =2.6 (p represented peak overpressure,and I represented specific impulse).The criterion of "overpressure-specific impulse" was used to estimate the death of rabbit,and the death curve of rabbit was determined as (p-0.1)(I-59) =2.6(p represented peak overpressure and I represented specific impulse).The critical overpressure was 0.1 MPa and the critical specific impulse was 59 Pa · s.Conclusions Under the explosion condition of 90 g TNT,the relationship between degree of lung injury in rabbits and explosion distance is established.Death curve of rabbits is determined based on the damage effect of shock wave peak overpressure and specific impulse on the lungs of rabbits,which is significant for predicting the blast injury.

Objective To systematically assess whether cilostazol can delay the progression or decrease the carotid intima-media thickness (clMT).Methods Papers on the effect of cilostazol on cIMT in randomized controlled trials and cohort studies were retrieved from a number of foreign and domestic databases.The data were analyzed by Review Manager 5.3.Results Six randomized controlled trials and two cohort studies were included in this study.A total of 1107 patients were divided into cilostazol therapy group (n=533) and control group (n=574).Meta-analysis showed that cilostazol therapy for 6 months,12 months,≥24 months could reduce the maximum cIMT with a mean difference of-0.04 mm (95％CI:-0.05--0.03,P=0.000),a mean difference of -0.04 mm (95％CI:-0.05--0.03,P=0.000) and a mean difference of-0.08 mm (95％CI:-0.11-0.05,P =0.000) respectively.Conclusion Cilostazol therapy for 6 months,12 months,24 months or more than 24 months can reduce the maximum cIMT,which is needed to be confirmed by studies with a large sample of clinical data.