OBJECTIVE To evaluate the efficacy of combined therapy on chronic rhinosinusitis(CRS). METHODS Thirty cases with CRS in stage Ⅱ-2 were treated by FESS. At 1,3,6-month after operation,endoscopy and nasal mucosa biopsy were performed and the clinic symptoms were reassessed. RESULTS Although fine mucosal epithelization was found in all cases at 6 month after operation,mild edema of mucosa and muciform secretion still existed in 10 cases. Mucociliary transport rate (MTR) was 3.63?1.74 mm/min before operation,and was 6.27?1.31 mm/min at 6-month after operation. Compared with that before operation,the MTR was significantly improved whereas it had not rehabilitated to normal status. The decrease of inflammatory cells and alleviation of submucosal edema were observed in the mucosa of maxillary sinus. Nevertheless,the number of goblet cells and submucosa glands did not improve significantly. The ultrastructure of the mucosa was not recovered completely at 6 month after operation. CONCLUSION With combined therapy on CRS for 6 months, clinical cure can be achieved,but mucosal inflammatory reaction is still existed.

Objective:To improve the safety,rationality and efficacy of medication for ovarian cancer patients complicated with cirrhosis by the participation of clinical pharmacists in the therapy. Methods:Clinical pharmacists participated in the therapy for an ovarian cancer patient with cirrhosis,and provided a rational and individualized therapeutic regimen through the drug experience of clinical pharmacists as well as the relevant medical guides and literatures. Results:The therapeutic efficacy was increased by the participation of clinical pharmacists in the therapy,the potential risk of the chemotherapy was avoided and the security of medication was assured. Conclusion:The participation of clinical pharmacists in therapeutic practice can improve the normalization of pharmacotherapy for ovarian cancer patients with cirrhosis,which also can provide ideas and methods for treating the similar patients.

Surgery is the only curative treatment modality for renal cell carcinoma (RCC). However, approximately 30% of patients who undergo successful nephrectomy for RCC will develop locoregional or metastatic recurrence. Effective treatment for recurrent or metastatic RCC is limited. It is known that conventional radiation therapy and chemotherapy are relatively ineffective for RCC patients with distant metastases. Although immune therapy with high dose interleukin can provide disease control for a portion of patients with advanced RCC, its therapeutic effect usually is not sustainable. In addition, substantial adverse effects and complications have limited the use of high dose interleukin treatment. Advances in the understanding at the molecular level of cancer have led to much progress in the development of anti-cancer agents, including drugs of targeted cancer therapy. Targeted therapy is not only effective in cancer treatment, but also has reduced adverse effects compared with conventional chemotherapy and immune therapy. Much progress in the treatment of advanced RCC by targeted therapy has been achieved in recent years. In this review, we will illustrate the roles, mechanisms and effects of several targeted therapy agents, including the two newly FDA-approved drugs, sorafenib and sunitinib, in the treatment of advanced renal cell carcinoma.

Eighty elderly patients undergoing elective resection for the prostate were randomly divided into two groups, the levobupivacaine (observe group) and bupivacaine (control group) were used for spinal anesthesia, respectively. The level of sensory block and maintain time were T7±4 and (224 ±28) min in observed group, those in control group were T6±3 and (227 ±30) min, respectively ( both P＞ 0. 05). The mean arterial blood pressure of control group was (71 ±8) -(72 ±8) mm Hg (1 mm Hg = 0. 133 kPa) from 5 to 30 min after injection; meanwhile that of observed group was(75 ± 9) mm Hg (P ＜ 0. 05). The incidences of hypotension and nausea were 10% (4/40) and 0% (0/40) respectively in observe group, and those were 30% (12/40) and 15% (6/40) respectively in control group (both P＜0.05). The results indicate that levobupivacaine and bupivacaine have similar anesthetic effects, but levobupivacaine has fewer side effects and is more suitable for elderly patients.

Objective To evaluate the application of fluorescent multiplex amplification of short tandem repeat(STR)for monitoring survival of engraftment after bone marrow transplantation(BMT).Methods Three STR loci named D12S391,D18S865 and D20S161 in 56 cases were detected by fluorescent multiplex amplification.PCR products were separated and typed by DNA Sequencer.Results The genotypes of STR in 52 recipient after bone marrow transplantation were completely identical with those of the donors.In another 4 cases the evidences of mixed chimerism were observed.Conclusion The system of fluorescent multiplex amplification of STRs exhibited high capacity of discrimination and low cost.Its application in the detection of STR after BMT is reliable,sensitive and simple.Combined with the clinical manifestation it can be used to evaluate the effect of BMT.

Objective To observe the effect of 2,3,5,4'-tetrahydroxy stilbene-2-?-D-glycoside (TSG)on learning and memory and free radicals metabolism in mice with dementia induced by ?-amyloid(A?).Methods The mice models were established by injection of A?1-40 into the right lateral ventricle,and the treatment group was administered with TSG for 8 weeks by gastrogavage.Morris water maze and step-through test were performed in all the mice and then the mice were killed and radioimmunoassay was used to detect the content of interleukin-6(IL-6).Results The learning and memory in model mice were worse and the cortical IL-6 content increased compared to the normal control mice.TSG improved the learning and memory of A?-induced model mice and reduced cortical IL-6 content.Conclusion TSG could improve the learning and memory of dementia mice and decrease cortical IL-6 content,indicating a promising prospect in the treatment of dementia disease such as Alzheimer's disease.

Standardized residency training is the main form of postgraduate medical education.In this article, we analyzed a delayed diagnosed case with Cushing syndrome.The patient saw the doctors in provincial level hospitals for many times within a year, while specialists missed diagnosis by only concerning the symptoms related to their own specialties, instead of integrating all the manifestations.We believe that standardized residency training provides residents a broader horizon of related specialties, which is irreplaceable by fellowship training program, and is the essential of comprehensive analysis of complex clinical situations.Standardized residency training will also be helpful for diminishment of the educational gap between different medical colleges and improvement the medical level of the whole nation.

Objective:To compare the antihypertensive effects of tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up.Methods:A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group,a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table,with 34 cases in each group.Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively.The blood pressure was recorded by benchtop mercury sphygmomanometer before tuina,immediately after tuina treatment,30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room.The total effective rate was observed.Results:The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P＜0.05).The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P＜0.05).Qiaogong (Extra) group had the highest total effective rate though there was no statistical difference in the total effective rate among the three groups (P＞0.05).Conclusion:Treating primary hypertension due to liver-fire flaming-up with tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively,among which Qiaogong (Extra) has the highest total effective rate.

ObjectiveTo observe the effect of 2,3,5,4'-tetrahydroxy stilbene-2-β-D-glycoside(TSG) on learning and memory ability and free radicals metabolism in dementia model mice induced by β-amyloid (Aβ).MethodsAβ1-40 was given to the right lateral ventricle in the model group, and the TSG had been administered to the therapy group for 8 weeks by gastrogavage.All the mice of different groups were tested with Morris water maze and step-through test. Then the mice were killed and biochemical assays of neurol MDA,MAO-B,T-AOC were performed.ResultsThe model mice showed worse ability in learning and memory compared with control mice. The MDA cotent, MAO-B activity in the cortical increased in model mice compared with normal control; TSG reduced the MDA content, MAO-B activity,and increased T-AOC activity.ConclusionTSG can improve the learning and memory ability of model mice, decrease peroxidation level of brain, and increase antioxidation ability of brain, which suggest that TSG may have a promising application in treatment of dementia disease such as AD.

OBJECTIVE:To observe the effect of2,3,5,4'-tetrahydroxy stilbene—2—?—D—glycoside(TSG)on learning and memory ability and neurotrophic factors of dementle model mice induced by D-galactose.METHODS:The mice were randomly divided into normal control,D-galatose model,VitE positive control,TSG low dose(0.033g/kg),TSG medium dose(0.1g/kg),TSG high dose(0.3g/kg)groups.The mice of various therapy groups excluding the normal Control group were in?jected with D-galactose(D-gal)solution s.c.(50mg/kg/day)over a60-day period,while normal control was injected with saline.At the same time,therapy groups were given TSG and positive control VitE(0.08g/kg)a day,and all therapy groups were administered by intragastrically for60days.Then all mice of different groups were tested with Morris water maze test,and five mice of each group were killed and the expression of nerve growth factor(NGF)and neurotrophin-3(NT-3)was determined with immunohistochemistry method.RESULTS:Injection of D-galactose for2months induced the learning and memory dysfunction of mice,and abated NGF and NT-3expression in hippocampal neurons.TSG improved the learning and memory ability of D-gal model mice,promoted NGF and NT-3expression in hippocampal neurons.CONCLUSION:SG can improve memory ability obviously and may prevent and cure dementia disease such as AD.