We report a case of primary sinonasal tuberculosis in a 23-year old man. He had a half-year history of headache and eye pain on the left side, and found the neoplasm of nasopharynx 15 days ago. Previously denied history of tuberculosis and contact history. After be admitted to hospital, twice biopsy from neoplasm of na- sopharynx were both of chronic inflammation. Coronal CT scan of the lesion when admission found the left parasellar region and the left sphenoid sinus soft tissue density increased, about 20 mm X 32 mm X 34 mm, left inferior wall between sella bone defects, and bone sclerosis, plain CT value was about 34 HU, the lesion protruded downward left the nasopharynx. Eight days after he was admissioned in hospital of sphenoid sinus biopsy showed granulomatous inflammation and tuberculosis diagnosis was considered. Review of the lesion is partial absorbed after 11 months of anti-tuberculosis treatment and now is still in follow-up.
Biopsy ; Headache ; Humans ; Male ; Sphenoid Sinus ; microbiology ; pathology ; Tomography, X-Ray Computed ; Tuberculosis ; diagnosis ; Young Adult

Aim Toinvestigatetheeffectofbencyclo-quidium bromide(BCQB)on mucus MUC5AC expres-sion induced by lipopolysaccharide in cultured human nasalepithelialcells(HNECs).Methods Primary culture of human nasal epithelial cells (HNECs)was randomly divided into control group (C,with no treat-ment),LPS group (LPS,with LPS 1 mg · L-1 added in),BCQB low dose group(BCQBL,with LPS 1 mg· L-1 and BCQB 10 -8 mol·L-1 added in),BCQB mid-dle dose group(BCQBM,with LPS 1 mg·L-1 and BC-QB 10 -7 mol·L-1 added in),BCQB high dose group (BCQBH,with LPS 1 mg·L-1 and BCQB 10 -6 mol· L-1 added in)and ipratropium bromide group(IB,with LPS 1 mg·L-1 and IB 10 -6 mol·L-1 added in).Af-ter incubation at 37 ℃with 5% CO2 for 24 h,the ex-pression of MUC5 AC mRNA was detected with Real-time PCR and the expression of MUC5 AC protein in HNECs was detected with Western blot,while the ex-pression of MUC5 AC protein in supernatant was detec-tedwithELISAineachgroup.Results Ascompared with control group,the expression of MUC5 AC mRNA and protein increased significantly in LPS group (each P<0. 01 ).As compared with LPS group,the expres-sion of MUC5 AC mRNA and protein decreased signifi-cantly in each group of BCQB(P<0. 01,P<0. 05), and there was no statistical difference between BCQB high dose group and control group (each P>0. 05 ). Conclusion Bencycloquidiumbromidecansuppress MUC5 AC expression induced by LPS in cultured hu-man nasal epithelial cells,indicating that BCQB may be a new drug for nasal mucous hypersecretion diseases.

Objective Study the useful effect of the subjective and objective assessmentscale in fungal‐rhino‐sinusitis (FRS) patients before and after endoscopic sinus surgery ,and thier transition rules .Methods Visual analog scale (VAS) ,sino‐nasal out‐come measures 20 (SNOT‐20) ,Lund‐Mackay CT score and Lund‐Kennedy nasal endoscopy score were used to prospective evaluate 130 cases of FRS patients at the time of before endoscopic sinussurgery ,the 3rd month and the6thmonth after survey ,and correla‐tion analysiswas took between the various scales .Results At the time ofbeforesurgery ,the 3rd month and the 6th month after the endoscopic sinus surgery ,the VAS ,SNOT‐20 ,Lund‐Mackay sinus CT scores and Lund‐Kennedy endoscopic score were significantly correlated (P< 0 .05) ,but At the time ofbeforesurgery ,VAS and Lund‐Kennedy nasal endoscopy scorehas no correlation(P>0 .05) .Except for SNOT‐20 scores at the time of 3rd month had relationship with preoperative scores(P<0 .05) ,there were no sig‐nificant relation of each scales that preoperative scores compared with 3rd month of 6th mouth(P> 0 .05) .The difference ofSNOT‐20 ,VAS ,Lund‐Kennedy nasal endoscopy scorewas statistically significant compared to each other at the time of 3rd month and the 6th month after surgery (P<0 .05) .Conclusion Subjective combined with objective scale can be a better response for patients be‐fore surgery ,which may be helpful for the choosing of operation time;combination of postoperative subjective evaluation with objec‐tive evaluation and following‐up ,may be a more effect way for patient to kmow the outcome after surgery .

To carry out bilingual education among seven-year-program students of clinical medicine is for further raising of professional English level of the students so as to cultivate highlevel medical personnel. We put emphasis on teaching material,the ability of teachers and courseware ,adopting the form and methods to make students comprehend and memorize easily, which has raised the students’interests and ability and helped them lay a solid foundation for the study of clinical knowledge.

The application and expanding of nasal endoscopic surgery,an epoch-making transform of rhinology,have a very close associations with medical imaging,which includes anatomy photograph,conceptual diagram,radiological imaging,nasal endoscopic image display system,operation photographic recording and computer assisted instruction courseware,etc.It is important to collect the medical imaging through various means and set up medical imaging resources library for nasal endoscopic surgery teaching.

On the basis of experiences in advanced otolaryngology-head & neck surgeons teaching,we realized that it was important to accomplish the following measures:to insist on entering instruction,to make reasonable training plan,to hold regular lecture,to attach importance to applied anatomy teaching,to cultivate clinical ability,to standardize medical record writing,to strengthen communication between doctors and patients and to strengthen medical morality construction.Only by doing so can we improve the advanced education quality.

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.

Objective:To evaluate the role of natural killer T cells in renal fibrosis in mice with acute kidney injury (AKI).Methods:Twenty-four clean-grade healthy male C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), AKI group (group A), control plus CD1d antibody group (group C-MA), and AKI plus CD1d antibody group (group A-MA). The model of renal fibrosis in mice with AKI was established by intraperitoneal injection of folic acid 250 mg/kg.In group C, homotypic control antibody 20 mg/kg was injected via the tail vein.In group AKI, homotypic control antibody 20 mg/kg was injected via the tail vein at 24 h before establishing the model. In group C-MA, anti-CD1d monoclonal antibody 20 mg/kg was injected via the tail vein.In group A-MA, anti-CD1d monoclonal antibody 20 mg/kg was injected via the tail vein at 24 h before establishing the model.On the 14th day after folic acid injection, blood samples were taken from eyeballs to determine the concentrations of blood urea nitrogen (BUN) and creatinine (Cr) in serum.Then the mice were sacrificed, and the renal tissues were taken for Sirius red staining and HE staining to determine the area of renal fibrosis, and renal injury was scored.The expression of fibronectin (FN), type I collagen (Col-Ⅰ) and alpha-smooth muscle actin (α-SMA) in renal tissues was detected by immunofluorescence method.The expression of interleukin (IL)-4, IL-13, arginase-1 (Arg-1) and found in inflammatory zone 1 (FIZZ1) mRNA in renal tissues was detected by real-time polymerase chain reaction. Results:Compared with group C, the concentrations of BUN and Cr in serum, renal injury score, and area of renal fibrosis were significantly increased, the expression of FN, Col-Ⅰ and α-SMA and IL-4, IL-13, Arg-1 and FIZZ1 mRNA was up-regulated in A and A-MA groups ( P<0.05), and no significant change was found in the above indexes in group C-MA ( P>0.05). Compared with group A, the concentrations of BUN and Cr in serum, renal injury score, and area of renal fibrosis were significantly decreased, the expression of FN, Col-Ⅰ and α-SMA and IL-4, IL-13, Arg-1 and FIZZ1 mRNA was down-regulated in group A-MA ( P<0.05). Conclusion:Activation of natural killer T cells is involved in the process of renal fibrosis in mice with AKI, and the mechanism may be related to promoting the release of Th2 cytokines and M2 polarization of macrophages.

Objective To explore the imaging characteristics of common malignant sinonasal tumors for improving the diagnostic accuracy of the disease. Methods Radiological and clinical data of 78 patients with sino-nasal malignant tumors confirmed by pathological examination were retrospectively analyzed. Results Sinonasal malignant tumors lacked imaging specificity. Most of CT showed uneven soft tissue densities with unclear boundary and destruction of bone which invaded the soft tissue outside of the cavity including orbit or intra-cranium. There was moderate to remarkable enhancement of the lesion. T1WI in MR demonstrated homo-and hypo-intense signal , while T2WI revealed homo- and hyper-intense signal ,and post contrast MR imaging displayed heterogeneous con-trast enhancement. There was no significant statistical difference between CT and MRI in the detection rate of ma-lignant tumors(P > 0.05),but CT in combination with MRI improved the positive rate of detection(P < 0.05). Conclusions The imaging of sinonasal malignant tumors is complicated and lacks specificity. For complicated si-nonasal malignant tumors,enhanced CT in combination with MRI should be used to determine the nature and limi-tation of the tumor,and its relationship with the surrounding structures,resulting in improvement of the diagnostic accuracy of the disease.

Objective:To evaluate the role of interleukin-4 (IL-4) in renal fibrosis induced by acute kidney injury (AKI) in mice.Methods:Twenty-four male C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 4 groups ( n =6 each) using a random number table method: control group (group CON), AKI group, control plus anti-IL-4 antibody group (group CON-A), and AKI plus anti-IL-4 antibody group (group AKI-A). In AKI-A and AKI groups, folic acid was intraperitoneally injected to induce AKI in anesthetized mice, and the anti-IL-4 antibody 40 mg/kg and the equal volume of PBS were intraperitoneally injected, respectively, at 3, 6, 9 and 12 days after injection. The equal volume of PBS and anti-IL-4 antibody was given at the corresponding time point in CON and CON-A groups, respectively.The orbital blood samples were taken on day 14 after injecting folic acid for determination of the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The animals were then sacrificed, and renal tissues were obtained for examination of the pathological changes (using Sirius red staining and Masson staining) and for determination of the expression of fibronectin(FN), collagen-Ⅰ(Col-Ⅰ) and α-smooth muscle actin (α-SMA) (by Western blot) and expression of CD206, Arg-1 and FIZZ1 mRNA (by real-time polymerase chain reaction). The area of renal fibrosis was measured. Results:Compared with group CON, the serum BUN and Cr concentrations were significantly increased, the area of renal fibrosis was increased, and the expression of FN, Col-Ⅰ, α-SMA and CD206, Arg-1 and FIZZ1 mRNA in renal tissues was up-regulated in group AKI ( P<0.05), and no significant change was found in the parameters mentioned above in group CON-A( P>0.05). Compared with group AKI, the serum BUN and Cr concentrations were significantly decreased, the area of renal fibrosis was reduced, and the expression of FN, Col-Ⅰ, α-SMA and CD206, Arg-1 and FIZZ1 mRNA in renal tissues was down-regulated in group AKI-A ( P<0.05). Conclusion:IL-4 is involved in the process of renal fibrosis following AKI, and the mechanism may be associated with the regulation of macrophage M2 polarization in mice.