Objective To explore the effect of endoscopic sinus surgery on inverted papilloma of nasal cavity and paranasal sinuses in 30 cases.Methods 30 patients with inverted papilloma of nasal cavity and paranasal sinuses were operated on by endoscopic sinus surgery.Results During a follow-up of 2～3 years,only four cases recurred, Conclusion Endoscopic sinus surgery had advantsges of clear field and little injury,and therefore it was effective for inverted papilloma of nasal cavity and paranasal sinuses.

Optic neuritis is one of the most important neuro-ophthalmologic diseases which cause vision loss in young adults. There are obvious differences in the prevalence of optic neuritis in different countries and regions. Through the review of the related literature at home and abroad in recent years, this article summarizes the etiology and epidemiological characteristics of optic neuritis. lt is expected to provide reference and comparison for the epidemiological investigation of cross regional, multi-center cooperation.

Objective To summarize perioperative care and effect of surgical treatment of total anomalous pulmonary venous connection (TAPVC) in newborns and babies within 6 months.Methods From September 2001 to May 2013,ninetytwo consecutive patients with TAPVC received surgical correction under cardiopulmonary bypass (CPB) with moderate or deep hypothermia.The anatomic subtype included supracardiac type 48,intracardiac type 36,infracardiac type 6 and mixed type 2.There were 36 newboms.Pathological diagnosis was made by echocardiogram,computerized tomography and operative findings during operation.The option of procedure was determined by findings.Respirator assisted breathing after operation and cardiac function was maintained by a variety of positive inotropic drugs,to prevent the happening of the pulmonary hypertension crisis.Results Severely low cardiac output syndrome occurred in 8 patients and they died within 24 hours after operation.The remaining cases postoperative recover smoothly and receive postoperative follow-up about 1 month to 12 years,3 cases of postoperative pulmonary vein stenosis (PPVS) occurred.Conclusion Total anomalous pulmonary venous connection should be surgical treatment as soon as possible with satisfied effect.The key of perioperative care is maintenance of left heart function,negative balance of liquid,prevention and treatment of pulmonary hypertension.

OBJECTIVE:To study the preventive and therapeutic actions of L-arginine on pulmonary hypertension induced by high pulmonary blood flow volume.METHODS:Male SD rats were randomly divided into control group(n=6),shunt group (n=7) and shunt+L-arginine group(n=8).Abdominal aorta-inferior vena cava shunt was performed to make the blood flow from left to right,11 weeks later,mPAP was detected with right cardiac catheter;the structure of pulmonary vessels and expression of PCNA of smooth muscle cells were observed.RESULTS:The mPAP of shunt group was obviously higher than that of control(P

Objective To explore a feasible and effective method of purse-string suture and traction in proce- dures for prolapse and hemorrhoids(PPH)with circular stapler.Methods Width of resected mucosal band and ex- tent of residual hemorrhoid mucosal lifting were compared between two groups of patients with hemorrhoids receiv- ing PPH with“two-point retraction”method(group one,110 cases)and other retraction methods(group two,40 cas- es).Results For group one of 110 cases with“two-point retraetion”,resected mucosal band of all cases were intact and and average width ranged from 3.5 to 5cm.There was a completely residual hemorrhoid mucosal lifting(com- plete return of prolapsed hemorrhoid into the anal canal)in 100 cases of group one(91%).But in group two with other retraction methods,average width of resected mucosal bands ranged from 0.2 to 3.5cm and there was an in- complete band in 10 cases(25%).The rate of mucosal lifting in this group was only 62.5%(19/40).Conclusion Two-point retraction is a feasible,effective and simple method in PPH,resulting in an intact resected mucosal band and sufficient hemorrhoid mucosal lifting.So the two-point retraction PPH is worth to be extended for application.

Objective To determine clinical characteristics and the effects of drug-eluting stents on the occurrence of major adverse cardiac events during percuteneous coronary artery interventional(PCI)and long- term outcomes in patients with chronic renal insufficiency(CRI).Methods Nine hundreds and seventy three patients with angiographically-documented coronary artery disease(lumen inner diameter narrowing＞50%), included 516 patients complicated with experienced renal impairment(CRI group)and 457 with normal renal function(control group).Baseline clinical data and coronary angiographic features were recorded.Results Comparing with control group,patients in CRI group were older with higher incidence of hypertension or diabetes and simultaneously complicated by reduced left ventricular ejection fraction,and more complex coronary lesions(type C).During follow-up(mean 17 months),the mortality was significantly higher in CRI than in control group(6.2% vs 3.3%,P＜0.05),but the former with CRI was significantly lower by using drug-eluting stents in comparing with bare-metal stents(4.1% vs 8.5%,P＜0.05).Conclusion Patients with CRI often complicated with severe coronary artery disease,the mortality after PCI would be significantly reduced by using drug-eluting stents.

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.

Background The establishment of diabetic animal model is a crucial step for the study about diabetic eye diseases. At present,the main modeling method include the injection of streptozotocin and alloxan. But the shortcoming of the former is an expensive price, and that of the later is high death rate of animals. Objective This experiment was to discuss the way which decrease the death of alloxan-injected animal and explore the effects of high blood glucose on the posterior capsular opacification (PCO). Methods Forty clean healthy male New Zealand white rabbits were randomly divided into 2 groups. 90mg/kg of alloxan were injected via ear vein once in 20 rabbits to create the diabetic animal models,and the equivalent amount of normal saline solution was injected at the same way as normal blood glucose group. The successful models were selected in the animals with the blood glucose level over 12. 0 mmol/L two weeks later, and PCO of lens were graded based on the method of Odrieh under the slit lamp. Extracapsular lens extraction was then performed on the right eye of rabbits in both groups, and the posterior capsules were obtained from these eyes at the 6th, 10th and 14th days after operation. The expression of proliferating cell nuclear antigen ( PCNA ) in posterior capsular lens epithelial cell was detected by immunohistochemistry. Results The modeling successful rate was 70% after injection of alloxan. The body weight of rabbits in high blood glucose group was significantly lowed and the blood glucose was significantly elevated in comparison with normal blood glucose group ( all P<0. 05). Two weeks after surgery ,2 eyes occurred 2 grade of PCO and only one eye showed the 1 grade of PCO in the high blood glucose group. However, 1 grade of PCO was found in 3 eyes in the normal blood glucose group. Biopsy revealed that PCNA was positively expressed in the cell nuclei of LECs in high blood glucose group rather than the normal blood glucose group from the 10th day after surgery. The proliferation index of PCNA was 0. 86±0. 04 and 0. 25±0. 03 respectively in high blood glucose group and normal blood glucose group, showing a significant difference between them (t = -16. 171 ,P = 0. 000). Conclusion Stable diabetic models of rabbits can be created by intravenous injection of 90 mg/kg alloxan. High blood glucose level is one of the important factors for the development of PCO.

Objective To study the role of vascular resection in the radical resection of hilar cholangiocarcinoma. Methods One hundred and forty-two cases of hilar cholangiocarcinoma (HC) data during July 2009 and December 2014 were analyzed retrospectively .After sufficient preoperative management including relieving jaundice , three dimensional assessments were evaluated and then surgical planning was designed. Results One hundred and forty-two cases underwent surgery after adequate preoperative preparation and evaluation, of whom 16 patients had vascular resection. Portal vein resection was performed in 11 cases, in which the portal vein wedge excision was performed in 4 cases, the portal vein anastomosis in 6 cases, and right anterior portal vein resection and reconstruction was performed in 1 case. Because of tumor invasion in the right hepatic artery, 4 patients underwent right hepatic artery resection and saphenous vein reconstruction, and 1 patient underwent right hepatic artery anastomosis. Postoperative complications were as follows:bile leakage in 1 case, no abdominal bleeding and abdominal infection, and no vascular thrombosis-related complications, and the overall complication rate was 1/16. There was no perioperative death . The follow-up results was as follows: 1 patient died 3 months after surgery, 1 died of liver metastasis after 9 months, 2 cases were lost to follow up, and the rest patients were still followed up. Conclusions Vascular resection for hilar cholangiocarcinoma helps to improve tumor resection rate and prognosis in large medical centers. With the use of three dimensional assessment, preoperative management and reasonable surgical strategy can reduce postoperative complications and ensure safety for hilar cholangiocarcinoma resection.

AIM:To compare the difference between Shuxiong Tablet(Radix et Rhizoma notoginseng,Flos Carthami,Rhizoma Chuanxiong)(SXT) and its effective compounds group(SECG) in anti-inflammatory,relieving pain,anticoagulation,anti-thrombus and myocardial protection.METHODS:We adopted experiments of carrageenan-induced paw edema,hot water shrink trail,clotting time in mice,and thrombus in arteriovenous shut,and pituitrin induced acute myocardial ischemia in rats.RESULTS:Both of SXT and SECG could inhibit the tumefaction,decrease PGE_2 and SOD in inflammatory tissue;enhance the pain threshhold of mice;extend clotting time;inhibit the thrombosis;inhibit myocardial ischemia,significantly decrease CK,LDH,MDA and increase SOD in myocardial tissue.CONCLUSION:SXT and SECG have the same effects on anti-inflammatory,relieving pain,anticoagulation,anti-thrombus and myocardial protection.Further more,their dose-response relationship curves were similar,suggesting that SECG having the main effective components of SXT,could take place of SXT in clinical research.