Rhinitis,sinusitis,nasal polyps and bronchial asthma are common respiratory diseases,and they have some similarities in etiology,pathogenesis,histopathology and pathophysiology.Many patients suffer from these diseases in succession,or at the same time.Many domestic and international clinical and fundamental studies have aroused widespread concern about the relevance of these diseases,with the correlations between nasal polyps-sinusitis and asthma that attribute to much attention.However,the relevance of extent on the study of these diseases,as well as diagnosis,treatment,and concept is not very clear yet.The main target of this article is to discuss the above issues and remind our clinicians to pay more attention to understand the comprehensive relationships of rhinitis,sinusitis,nasal polyps and bronchial asthma,and provide references for the strategy of rational and effective treatment options.

Objective To observe the fluctuations of blood glucose in type 2 diabetic patients treated by insulin hypodermic injection in different sites.Methods 30 patients with type 2 diabetes were randomly divided into three groups:abdominal,edltoid region and lateral femoral subcutaneous injection group.After half a year of insulin therapy,dynamic glucose monitoring for consecutive(71±10)hours was conducted,and(847±80)results of glucose Level were obtained.Results The average glucose had no difference in three group,but diurnal maximum and maximum fluctuation amplitude in patients of abdominal subcutaneous injection group were significantly lower than the Other groups(P＜0.05).The time percentage of glycemic fluctuations within 3.6～10.0mmol/L and diurnal minimum was higher compared to other groups(P＜0.05).Conclusion The site choice of insulin subcutaneous injection can influence the fluctuations of blood glucose in type 2 diabetes mellitus and abdominal subcutaneous tissue was the most ideal of the three subcutaneous injection sites.

Objective To analyze the predictive value of platelet related indicators for patent ductus arteriosus (PDA) in extremely low birth weight infants (ELBW). Methods The data of 79 ELBW infants born from June 2013 to June 2016 were retrospective analyzed. There were 48 cases without PDA (nPDA group) and 31 cases with PDA (PDA group). Among 31 cases with PDA, there were 17 cases of non-haemodynamically significant PDA (nhsPDA group) and 14 cases of haemodynamically significant PDA (hsPDA group). The clinical feature and platelet related indicators among nPDA group, PDA group, nhsPDA group and hsPDA group were compared. Multivariate logistic regression was used to analyze the effects of various factors on the occurrence of PDA. ROC curve analysis was performed to evaluate the early predictive value of platelet related indicators for PDA. Results Compared with the nPDA group, the PDA group had a smaller gestational age, a higher proportion of male infants, and a smaller platelet distribution width (PDW), and there were statistically significant differences in all of those (P all<0.05). Multivariate logistic regression analysis indicated that the risk of PDA was increased as the PDW was decreased (OR=1.26, 95%CI: 1.05~1.52). The ROC curve analysis showed that the best diagnostic value of PDW was 13.4 GSD, and the sensitivity of early prediction of PDA was about 67.74%, and the specificity was 68.75%. Compared with nhsPDA group, hsPDA group had a smaller gestation age, lower cesarean section rate, and there were statistically significant differences (P all<0.05). There was no significant difference in platelet related indicators between hsPDA group and nhsPDA group (P>0.05). Conclusion PDW has certain early predictive value for PDA in ELBW. ELBW infants with PDW<13.4 GSD need to be watched closely for the occurrence of PDA.

Objective To discuss the risk factors for occurrence of acute gout in the patient with hyperuricement so that the countermeasure can be made.Methods The data of routine health examination was collected and questionnaire was made in 1847 hyperuricemic patients.The single factor analysis and the Logistic regression analysis were used to screen the risk factors for acute gout such as age,sex,course of diseases,FBS,lipid,uric acid,and complicationas.Results Sex,BMI,positive family history and complication with hypertension and hyperlipidemiaand have the siginificantly influence on the attack of acute gout in hyperuricemic patients.Conclusion The nurse should know very well the risk factors for acute gout and its induction factors,strengthen patient's health education and make different measures for different factors.

Objective To investigate the clinicopathological characteristics,immunophenotype and the differential diagnosis of ectopic hamartomatous thymoma (EHT).Methods Three cases with EHT were studyed for clinicopathological and immunohistochemical features, the available literature on this subject was reviewed as well.Results The tumors of 3 patients with EHT were located at left lower neck,right supraclavicular area,and left supraclavicular area respectively,and were underwent local resection.The well-defined nodular tumors were en-capsulated with gray-yellowish cut surface,with size of 2.5 cm ×1.9 cm,4.5 cm ×4.5 cm,and 3.0 cm ×2.5 cm,respectively.Microscopi-cally,the tumors were composed of spindle cells,epithelium,and adipose tissue with the predomination of spindle cell.A gradual transition from epithelial cells to spindle cells was frequently present.Immunohistochemically,both the spindle cell and epithelial components were dif-fusely and intensely positive for AE1 /AE3,CK7,CK19,and P63.Two patients with EHT were followed up for 18 and 27 months,both without any evidence of metastasis or recurrence.Conclusion EHT is an exceedingly rare benign tumor with distinctive location and histological fea-tures and should be differentiated from biphasic synovial sarcoma,malignant schwannoma with epithelial differentiation,mixed tumor,thymoli-poma,et al.The total focal excision is the first treatment of choice for EHT.

ObjectiveTo explore the control factor of pulmonary microvascular endothelial cells in pulmonary hemorrhage with the RhoA-Rock pathway inhibitors.MethodsHuman pulmonary rnicrovascular endothelial cells were conventionally cultured,and were divided into four groups:control group,inhibitor group,hypoxia group and hypoxia group with inhibitor.As different fluorescein lsothiocyanate-phalloidin and filamentous actin (F-actin) in cytoplasm combined,it issued red fluorescence.We observed the dynamic changes of F-actin by laser scanning confocal microscope in hypoxia human pulmonary microvascular endothelial cells and recorded the value of fluorescence.ResultsThe mean fluorescence intensity of F-actin of hypoxia group in 1 h,12h and 24 h was (64.3 ±5.5)％,(60.3±4.2)％,and (47.8 ±4.6)％ as compared with the control group;the ratio of hypoxia group with inhibitor was (66.2 ±3.2)％,(67.1 ±6.2)％,and (72.5 ± 6.1 ) ％ as compared with the control group.The mean fluorescence intensity of F-actin decreased obviously after 1 h hypoxia treated to cells,decreasing to (64.3 ± 5.5 ) ％ of the control group (P ＜0.05 ) ;to 24 h,decreasing to (47.8 ±4.6) ％ of the control group(P ＜0.05).The mean fluorescence intensity of F-actin decreased to (66.2 ± 3.2) ％ of the control group after 1 h hypoxia treated in inhibitor group,which was more than 1 h in the hypoxic group.F-actin decreased obviously to (72.5 ± 6.1 ) ％ of the control group after 24 h hypoxia treated in inhibitor group.There was significant difference comparing with the hypoxia group after 24 h hypoxia(P ＜0.05).The mean fluorescence intensity of F-actin of inhibitor group without anoxic was invariant comparing with the control group(P ＞0.05).Cortex-like structure disappeared and the stress fibers arranged disorderly after hypoxia.Actin depolymedzated and broke gradually with the extension of hypoxia time.If to be hypoxic after pretreated with RhoA-Rock pathway inhibitor,cortex-like structure by the composition of pednuclear F-actin reappeared,distribution and arrangement of stress fibers in the cytoplasm tended to rule.ConclusionThe RhoA-Rock pathway mediates the damage on F-actin of pulmonary microvascular endothelial cells after hypoxia.Interfering with the RhoA-Rock pathway inhibitors can provide a new direction for the treatment of neonatal pulmonary hemorrhage.

DNA topoisomerase is a basic enzyme in eucaryon and prokaryotic cells, which distributes in cell nucleus generally. DNA topoisomerase plays important roles in the process of duplication, transcription, translation, recombination and chromosome monomer isolation to control, keep and modify the DNA topology. It is reported that DNA topoisomerase has a high expression level, which related with the mechanism of many antitumor drugs.

Objective To explore artifactual responses of auditory steady-state reponses (ASSRs) to bone-conduction stimuli.Methods The present study involved a group of subjects,aged between 5 to 39 months,with bilateral profound sensorineural hearing losse.Recorded were the reponses to multiple bone-conducted 0.5,1,2,4 kHz tone pips repeated at the rates of 77～101 Hz.All the subjects were sedated by Hydrate Chloride during the testing.Results Artifactual ASSRs were seen at 115 and 100.5 dB (re:1?N) (The above levels are equivalent to around 60 dB HL) at 1 and 4 kHz.No artifactual responses were recorded at 0.5 and 2 kHz stimuli at the maximum output level.Conclusion Bone-conducted hearing loss greater than moderate can not be tested reliablely due to artifactual responses and lower maximum output level than that of air conduction.

Objective:To understand the current situation of human resources in the hemodialysis centers of different levels of hospitals in Beijing, and to provide reference data for themedical institutions at all levels to adjust the related human resources programs.Methods:Based on the self-designed questionnaire, the basic situation of 123 hemodialysis centers and the allocation of human resources of doctors, nurses and engineers in medical institutions of Beijing were investigated and analyzed.Results:Each nurse in hemodialysis center was responsible for (4.98± 0.74) hemodialysis patients at the same time in each treatment shift. The specialized nurses accounted for 23.32% of the total registered nurses. The ratio of engineers to dialysis machines was 1∶25.76. The proportion of doctors, nurses and engineers with intermediate professional titles or above was 82.47%, 33.08% and 29.81% respectively. The proportion of doctors with graduate education or above was 51.13%. The proportion of nurses and engineers with bachelor degree or above was 56.12% and 51.56% respectively. The differences in the professional titles and the highest academic qualifications of the employees (doctors, nurses and engineers) between tertiary hospitals and non-tertiary hospitals were statistically significant ( P < 0.05). Conclusion:The number of personnel in Beijing hemodialysis centers is basically in a similar proportion, but there are some differences between the hemodialysis centers of tertiary hospitals and those of non-tertiary hospitals in terms of age composition, working years, professional titles and educational background. It is necessary to optimize the allocation of human resources in hemodialysis centers of different levels of hospitals, further strengthen the training of professional talents and the cooperation of multidisciplinary teams, to promote the sustainable development of medical service quality.