Objective:To investigate the clinical effect of surgical procedures on patients with chronic sinusi-tis. Method: 104 patients with chronic sinusitis were treated by endoscopic and Caldwell-Luc's approaches. Thelesions were cleared away completely. Result:The clinical cure rate was 96.1％ after 6～12 months (average 9months ) follow up. Conclusion:It suggests that patients with severe maxillary sinus diseases might be cured byendoscopic and Caldwell-Luc's procedure.

To analyze the actuality in the education of forensic postgraduates and discuss the cultivating goal,the ability cultivation of innovation and practice.There are scientific research degree and professional degree in the forensic medicine.

ObjectiveTo assess whether intravenous contrast medium would result in acute kidney injury (AKI), and to determine the risk factors associated with contrast induced AKI (CI-AKI) and its outcome.Methods A retrospective observational study was conducted in intensive care unit (ICU) of Fuyang People's Hospital in Zhejiang Province from January 1st 2011 to December 31st 2014. All enrolled critically ill patients had accepted CT scan, and the hospital length of stay was longer than 48 hours, and the patients who needed renal replacement treatment were excluded. Patients were divided into contrast medium group and control group. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria (serum creatinine content over 26.4μmol/L or 50% increase of it from baseline within 48 hours). The incidence of AKI was compared between the two groups, and risk factors for CI-AKI were determined by multiple logistic regression analysis. The relationship of CI-AKI and outcomes were also analyzed. Results A total of 2 370 critically ill patients were enrolled during the period. 474 (20.0%) of the 2 370 patients received contrast medium, and 70 of them suffered from CI-AKI (14.8%). In 1 896 patients who did not receive contrast medium, 235 of them suffered from AKI (12.4%). There was no significant difference in the incidence of AKI between two groups (χ2= 1.905,P = 0.168). After several confounding factors were adjusted, multiple logistic regression analysis showed that contrast medium was not found to associate with AKI in critically ill patients [odds ratio (OR) = 1.66, 95% confidence interval (95%CI) = 0.72-3.90,P = 0.201], and high acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (OR = 1.70, 95%CI = 1.33-2.40,P< 0.001), sepsis (OR= 8.06, 95%CI =3.28-17.80,P< 0.001), shock (OR= 3.57, 95%CI = 1.73-8.01,P< 0.001) and use of nephrotoxic agent (OR= 1.96, 95%CI = 1.25-2.63,P = 0.015) were risk factors of CI-AKI. Ten of 70 patients with CI-AKI died (14.3%), and 21 out of 404 patients without CI-AKI, died (5.2%). There was no significant difference in the mortality rate (χ2= 8.060, P = 0.005). It was shown by multiple logistic regression analysis that age (OR=1.30, 95%CI = 1.05-1.71,P = 0.027), male sex (OR = 1.13, 95%CI = 1.05-1.20,P = 0.039), APACHEⅡscore (OR = 1.07, 95%CI = 1.03-1.18,P< 0.001), and sepsis (OR = 3.29, 95%CI = 1.92-6.46,P< 0.001) were highly associated with mortality of critically ill patients in whom contrast medium was used. However, the occurrence of CI-AKI showed no influence on the mortality rate (OR = 1.70, 95%CI = 0.88-3.56,P = 0.227).Conclusions The use of contrast medium is not a risk factor of CI-AKI in critically ill patients. CI-AKI will not raise mortality rate in ICU patients.

Objective To investigate relation of IL-18 and collagen fibre(CF) with plaque stability in aorta atherosclerotic lesion.Methods Morphology and content of CF in rupture of aorta atherosclerotic group(A group),non-rupture of aorta atherosclerotic group(B group) and normal aorta group(C group) were examined by Massion's staining.Expression of IL-18 by was measured immunohistochemical staining among three groups.Results Increasing and arranging turbulence of the CF was found in tunica intima,middle layer and tunica adventitia in A and B groups.Around necrosis of atheromatous plaque,CF significantly increased and arranged turbulence,but the CF decreased or disappeared in necrosis area of atheromatous plaque in A group.The CF significantly increased,arranged turbulence and extended to SMCs in necrosis of atheromatous plaque in B group.Arranging orderliness and absence of disruption of the CF was recorded in C group.Percent age of CF content was significantly different among three groups(P

Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bi -polar radio frequency current ablation .Methods All patients in our study were divided into three groups including the ones who had accept -ed bipolar radio frequency current ablation because of atrial fibrillation ,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation .All patients accepted TTE before and after operation .Results The rate of transverse diameter change of ablation group (24.24 ±8.67)%was larger than those of other two groups (P<0.05).Left atrial chan-nel capacity volume change rate of ablation group (17.18 ±3.26)%were larger than the values of the group who were suffering atrial fibrilla-tion but refused ablation advice (0.86 ±0.26)(P<0.05).Left atrial total ejection fractions of ablation group (202.41 ±81.59)%were lar-ger than the values of the group who were suffering atrial fibrillation but refused ablation advice (109.53 ±60.91)%( P<0.05) .And its ac-tive ejection fractions(12.18 ±3.48)%,total ejection fractions(41.31 ±8.26)%and so forth were less than the group who maintained si-nus rhythm before operation(21.33 ±5.61)%,(45.05 ±7.37)%,respectively (P<0.05).Left atrial posterior wall center and cardiac basal segment strain(14.34 ±9.47)%,(13.20 ±8.38)%,respectively,and strain rate values after operation of ablation group were less than other segments .Conclusion Left atrial structure remodeling inversion was not obviously 3~6 months after bipolar radio frequency cur-rent ablation .And at the same time ,the improvement of left atrial storage function was not obviously compared with the group who refused ab -lation advice,left atrial channel function compensation degree descended obviously left atrial co -pumping function in ablation group increased obviously,left atrial posterior wall center and cardiac basal segment systolic and distolic function were less than other segments of left .

Objective: To analyze the epidemiological characteristics of public health emergencies in Zhoushan City from 2004 to 2021, so as to provide insights into the prevention and control of public health emergencies. Methods : Data pertaining to public health emergencies and their associated data in Zhoushan City from 2004 to 2021 were retrieved from Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The type, date of occurrence and places of public health emergencies were descriptively analyzed. Results: Sixty public health emergencies were reported in Zhoushan City from 2004 to 2021, during which 1 527 cases were reported and 52 661 individuals were involved, with an attack rate of 2.90% (95%CI: 2.78%-3.02%). There were 3 Ⅲ-level (5.00%), 13 Ⅳ-level (21.67%) and 44 unclassified public health emergencies (73.33%), and no Ⅰ- or Ⅱ-level emergencies were reported. The reported public health emergencies peaked in January (9), August (6) and December (9), and there were 47 infectious disease emergencies (78.33%), 10 food poisoning emergencies (16.67%) and 3 chemical gas poisoning emergencies (5.00%), respectively. The four most common infectious disease emergencies included other infectious diarrhea (25.53%), COVID-19 (17.02%), influenza (14.89%) and chickenpox (14.89%). School and kindergarten were predominant places where public health emergencies occurred (39, 65.00%), and the three most common public health emergencies reported by schools and kindergartens included other infectious diarrhea (28.21%), influenza (17.95%) and chickenpox (17.95%). Conclusions Infectious disease emergencies were predominant public health emergencies in Zhoushan City from 2004 to 2021, and Ⅳ-level and unclassified emergencies were predominant. Public health emergencies mainly occurred in schools and kindergartens.

Objective The occurrence and progression of renal cell carcinoma ( RCC) is complicated process associated with DNA abnormal methylation , histone modification , and Wnt signaling pathway .This study aimed to investigate the expression of histone methylase SET8 in RCC, its relationship with the Wnt signaling pathway , its action mechanism in RCC , and its clinical significance . Methods We selected 50 cases of RCC treated by radical nephrectomy , detected the expression of SET 8 in the RCC and adjacent noncancerous kidney tissues by immunohistochemical EliVision two-step staining with β-catenin.We compared the expression levels of SET8 and β-catenin in the two types of tissue and analyzed their relationship with the patients′clinical information and the pathologic stage and grade of tumor as well as the correlation between the SET 8 andβ-catenin expressions . Results SET8 was mainly express in the cytoplasm of the RCC and noncancerous kidney tissues , partially in the cell membrane and nucleus , while theβ-catenin protein chiefly in the cell membrane of renal tubular epithelial cells in the normal kidney tissue .The expression levels of SET 8 and β-catenin in the RCC tissue were closely related to the TNM stage and tumor grade (P<0.05).The positive expression of SET8 in the RCC tissue (76%[38/50]) showed no significant difference from that in the ad-jacent noncancerous kidney tissue (66% [33/50]) (P>0.05), but that of β-catenin was remarkably higher in the former (68%[34/50]) than in the latter (4%[2/50]) (P<0.01).There was a positive correlation between the positive expression of SET 8 and the abnormal expression of β-catenin (r=0.219, P<0.05). Conclusion SET8-activated H4K20me-1 controls the activation and abnormal activities of the Wnt signaling pathway , affects the gene transcription and cell activity , and participates in the occurrence , progression, and distant metastasis of RCC .

Objective To investigate the clinical value of prenatal MRI in the diagnosis of fetal bowel obstruction.Methods Pregnant women suspected to have fetal abdominal abnormalities by ultrasonography were suggested to undergo MRI examinations within two days.Scanning sequence included FIESTA,SSFSE and T1WI SPGR sequence,with field of view focused on the fetal abdomen.After the final diagnoses of the cases were obtained by induced labor pathological examination or postpartum imaging or operation,the imaging data and the clinical data were reviewed and analyzed retrospectively.Results A total of 23 cases with bowel obstruction were included in the study.Four fetuses with duodenal atresia showed low T1 signal,high T2 signal characterized by double-bubble sign on MRI.There were 10 fetuses with jejunoileal atresia,showing bowel dilatation and hyperintense micro-colon on T1WI.Five cases of them depicted expansion of the terminal ileum with high T1 meconium signal.One each fetus had colonic atresia,intestinal malrotation with double-bubble and whirl sign.Annular pancreas with double-bubble sign and pressure trace of the bracket shape was detected in 3 fetuses.Meconium peritonitis was present in 4 fetuses,with 2 of them showing dilatation of intestine,ascites and pseudocysts.Conclusions According to the signal characteristics of amniotic fluid and meconium in the gastrointestinal tract on MRI,the obstructive level and development status of the distal bowel can be determined with MRI.It can provide additional information to ultrasonography,which brings clinical significance to prenatal diagnosis and intrapartum surgical operation.

ObjectiveTo investigate the effect of different cyclic strengths on expressions of phospholipase A2 (PLA2) and cyclooxygenase (COX) in human tenocytes.MethodsHuman tenocytes were uniaxially stretched with different stretching intensity (4％, 8％ and 12％) under 0.5 Hz for four hours.Non-stretched tenocytes were applied to the control group.The expressions of cytosolic PLA2(cPLA2), COX1 and COX2 were measured by Western blot and RT-PCR.The secretion of secretory PLA2 (sPLA2) was measured by ELISA.Results The mRNA expressions of cPLA2, COX1 and COX2 in control group, 4％, 8％ and 12％ stretch groups showed an increase trend.But protein expressions of cPLA2 and COX1 in 4％ stretch group were increased insignificantly compared with the control group (P ＞ 0.05).Protein expressions of cPLA2 and COX1 in 8％ and 12％ stretch groups were increased more significantly compared with the control group (P ＜ 0.01).The COX2 expression in 4％,8％ and 12％ stretch groups showed statistical difference compared with that in the control group (P ＜0.01) and the difference increased with stretch intensity.There was no different expression of sPLA2 between 4％ stretch group and control group (P = 0.260).However, expression of sPLA2 was increased markedly in 8％ and 12％ stretch groups (P ＜ 0.01).ConclusionsThe expressions of human tendnocytes PLA2, COX1 and COX2 in vitro are positively correlated with stretch intensity.PLA2/COX system may be a new molecule target in clinical treatment of tendinopathy.

ObjectiveTo evaluate the clinical results of minimally invasive ankle arthrodesis with percutaneous cannulated screws.MethodsBetween April 2005 and October 2010, 12 patients with the ankle arthrodesis for unilateral severe arthritis (Kellgren-Lawrence class Ⅲ) were prospectively analyzed, including 2 cases of rheumatoid arthritis, 8 cases of post-traumatic arthritis, and 2 cases of osteoarthritis. There were 7 males and 5 females with an average age of 42.0 years(range, 25-7 1). The average disease duration was 7.3 years (range, 1-21). The anterior median incision of 3.0-5.0 cm was made to explore the ankle joint.The cartilage of tibial-talus joint was completely debrided. Two guide pins were inserted from posterosuperior to anteroinferior, and cannulated screws were implanted to fix ankle joint. All patients were physically examined with an extended protocol of questionnaires and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Scales. Ankle fusion in all patients was evaluated by clinical examination, and conventional radiography including anterior-posterior, lateral and mortise views of the ankle. ResultsAll 12 patients were followed up postoperatively for an average of 21.5 months(range, 6-55), and were proved be bone union by clinical examination and radiology with a mean of 13.5 weeks (range, 9-21). The AOFAS rating scale improved from a mean of 42.8±8.6 points at pre-operation to a mean of 66.6±5.4 points at post-operation 6 months,showing significant difference(t=-3.075, P=O.012), and to a mean of 72.3±4.6 at the final follow-up, also showing significant difference with pre-operation (t=-8.595, P=-0.006). There was no infection,local skin necrosis, screw loosing, and so on. ConclusionThe minimally invasive ankle arthrodesis with percutaneous cannulated scews is a recommend procedure, with mini-invasion, short surgery time, high fusion rate, good clinical outcomes, few complications.