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.

CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy is effective in refractory/relapsed (R/R) B-cell acute lymphoblastic leukemia (B-ALL).This review focuses on achievements,current obstacles,and future directions in CAR-T research.A high complete remission rate of 68 ％ to 93％ could be achieved after and-CD19 CAR-T treatment for B-ALL Cytokine release syndrome and CAR-T-related neurotoxicity could be managed.In view of difficulties collecting autologous lymphocytes,universal CAR-T is a direction to explore.Regarding the high relapse rate after anti-CD19 CAR-T therapy,the main solutions have been developing new targets including CD22 CAR-T,or CD19/CD22 dual CAR-T.Additionally,some studies showed that bridging into transplant postCAR-T could improve leukemia-free survival.Some patients who did not respond to CAR-T therapy were found to have an abnormal conformation of the CD 19 exon or trogocytosis.Anti-CD19 CAR-T therapy for R/R B-ALL is effective.From individual to universal CAR-T,from one target to multi-targets,CAR-T-cell has a chance to be off the shelf in the future.

Objective The epidemiology of Acinetobacter baumannii isolates from bloodstream infections,their antibiotic resistance profiles and virulence-associated factors were studied.Methods A total of 90 isolates from 17 hospitals were collected from the patients with bloodstream infections during July 2013 and July 2014.Vitek-2 Compact system was used for identification of the strains and antibiotic susceptibility testing.The epidemiology was studied by pulsed-field gelectrophoresis(PFGE).Drug-resistant genes and associated virulence genes were amplified by PCR.Results According to antimicrobial susceptibility testing,75 isolates are multi-drug resistant Acinetobacter baumannii.PFGE results showed that 75 multi-drug resistant Acinetobacter baumannii isolates belonged to eight clone types(A to H),with the A (n=51)and B (n=14)clone being the dominant PFGE clone types.Different clone isolates spread in different hospitals.Most of the hospitals were given priority to with clone A.Clone A only maintaining high sensitive rate to cefoperazone/sulbactam、amikacin and tigecycline.Virulence gene abaI,cusE,ompA,bap,bfms detection rates are 93.3% (84/90),92.2% (83/90),100.0% (90/90),84.4% (76/90),92.2% (83/90),respectively.There were 7 mucoid isolates,which are all multi-drug resistant Acinetobacter baumannii,all belong to clone B and all associated virulence genes can be detected.Conclusions The dominant clone type of multi-drug resistant Acinetobacter baumannii from bloodstream infections is clone A.The abaI-,bap-and bfms-positive strains are associated with a higher incidence of antibiotic resistance in most types of antimicrobials.The acquisition of mucous type may indicate the emergence of virulent strains,which should be paid attention to during clinical treatment.

Objective To analyse the imaging characteristics of the complications after nasal endoscopy.Methods The imaging findings of complications after nasal endoscopy were analyzed in comparison with clinic retrospectively.Results Among 18 patients,there were 15 cases with orbital bone defect (14 cases were at the medial wall),split of medial straight muscle in 1 case,6 cases with orbital inflammation, tortuous and grown optic nerve with indefinite margin in 5 cases,7 cases with local cranial base defect(the ethmoid plate in 5 and the superior wall of sphenoidal sinus in 2),2 cases with meningoencephalocele at defective ethmoid plate ,2 cases with cerebral spinal fluid nasal leak at defective right ethmoid plate and the superior wall of sphenoidal sinus in one respectively and 1 case with left nasolacrimal duct injury.Conclusion CT can definite the location and extent of the complications after nasal endoscopy,while MRI can be used in the diagnosis of the more complex complications of which.

Objective To investigate the diagnostic value of apparent diffusion coefficient in the evaluation of sinonasal masses.Methods Sixty-seven sinonasal solid masses over 1 cm in diameter confirmed by pathology were retrospectively analyzed,all patients underwent preoperative routine MRI with DWI,the ADC values were measured in ROI within the solid mass.The patients were divided into benign and malignant groups by the histopathology,according to pathological findings,the patients were further divided into the hematolymphoid tumors,the malignancy of epithelium and mesenchymal tissue,the benign tumors of epithelial and mesenchymal tissue,and vasogenic masses.ANOVA test and t test were used to compare the ADC values of different groups.The receiver operating characteristic curve (ROC) was constructed using various cut points of ADC for different parameters to confirm the diagnostic threshold value and evaluate the diagnostic efficacy.Results All lesions were solitary.There were 22 malignant tumors,of which 6 lesions were hematolymphoid tumors and 16 lesions malignancy from epithelium and mesenchymal tissue.There were 45 benign tumors,of which 22 lesions were benign tumors from epithelium and mesenchymal tissue and 23 lesions vasogenic masses.The mean ADC value of malignant and benign masses was(0.88 ± 0.26) × 10-3 mm2/s and (1.54 ± 0.41) × 10-3 mm2/s respectively.There was statistically significant differences between them (t =6.897,P ＜ 0.01).The mean ADC value was(0.63 ± 0.10) × 10-3 mm2/s in hematolymphoid tumors,(0.97 ±0.24) × 10 3 mm2/s in malignancy from epithelium and mesenchymal tissue,(1.38 ± 0.23) × 10-3 mm2/s in benign tumors from epithelium and mesenchymal tissue,(1.68 ± 0.49) × 10-3 mm2/s in vasogenic masses respectively.There was statistically significant difference among all 4 groups(F =22.788,P ＜ 0.01),and the differences between any 2 groups were still statistically significant(P ＜ 0.05).The area under the ROC calculated was 0.945.Using an ADC value of 1.08 × 10-3 mm2/s as the threshold value for differentiating malignant from benign lesions,the best result obtained had a sensitivity of 81.8％ (18/22),specificity of 97.8％ (44/45),accuracy of 92.5 ％ (62/67).Conclusion The ADC value is a valuable tool in differentiating benign from malignant masses and different kinds of masses in sinus and nasal cavity.

Objective To characterize the ocular findings on MRI in patients with Vagt-Koyanagi-Harada syndrome (VKHS)and its value for diagnosis. Methods The MRI findings of eyes in 14 patients (7 males, 7 females, age ranged 10-62 years) with VKHS were retrospectively analyzed. Results Choriodai thickening was found bilaterally in all 14 patients with isointense signal on T2 and T1 weighted images. Exudative retinal detachment was found in 6 patients (12 eyes) and 5 cases (10 eyes) showed abnormal thickening and enhancement of iris. Two cases were accompanied with optic neuritis. Homogeneous enhancement of lesions after administration of gadopentetate was observed in 11 patients. Conclusion M RI can characterize the ocular lesions and their extent in patients with VKHS, which makes MRI as a useful method to diagnosis and the follow-up of these patients.

Humans ; Male ; Middle Aged ; Neurofibroma ; pathology ; Pharyngeal Neoplasms ; pathology

To investigate the relationship between Snail and renal tubular epithelial-mesenchymal transition (EMT) or tubulointerstitial fibrosis (TIF) at tissue and cellular levels and to observe the changes of miRNA profile after transfecting Snail gene into human renal tubular epithelial cells (HK-2),to further elucidate the importance of miRNA in the pathogenesis of renal fibrosis.Methods The expression of Snail and EMT-related proteins vimentin,SMA,E-cadherin was detected by immunohistochemistry in renal tissues of 40 patients with IgA nephropathy.The expression of Snail,E-cadherin and SMA in normal control group,empty transfection group and Snail gene transfection group was detected by Western blot and RT-PCR.Furthermore,differentially expressed miRNAs were screened by gene chip.Results By immunohistochemistry,Snail expression was positively correlated with vimentin and SMA,negatively correlated with E-cadherin in IgA nephropathy.The higher degree of the TIF,the stronger the expression of Snail.Compared with the control group,the expression of Snail,vimentin and SMA in the snail transfected group increased.However,E-cadherin decreased at gene and protein level by the RT-PCR and Western blot (P ＜ 0.05).The difference was statistically significant.Five distinctly different miRNAs were screened by gene chip after Snail gene was transfected into HK-2 cells,and then 5 026 potential target genes were predicted.Conclusion Snail expression is closely related with renal tubular epithelial mesenchymal transition and tubulointerstitial fibrosis,and it may be used as a new target in EMT prevention.Differentially expressed miRNAs may be involved in the development of EMT and TIF.

Objective To investigate the value of high-frequency ultrasound in diagnosis of thyroid carcinoma by comparative analysis of high-frequency ultrasound and spiral CT imaging results. Methods The imaging results of patients with thyroid carcinoma proved by postoperative pathology or biopsy results were reviewed.High-frequency ultrasound and spiral CT were used to examine the 35 patients in The Tumor Hospital of Harbin Medical University between 2007 and 2009. Results Diagnosis of thyroid carcinoma by application of Highfrequency ultrasound were 27 cases, diagnosis rate was 77.1%(27/35);by spiral CT were 25 cases, diagnosis rate was 71.4% (25/35);comparison of the two methods showed no significant difference (x2= 0.3, P ＞ 0.05). Combined application of high-frequency ultrasound and spiral CT diagnosed 33 patients with thyroid carcinoma, diagnosis rate was 94.3%(33/35), which was significantly higher than that of high-frequency ultrasound alone or that of spiral CT alone(compared with high-frequency ultrasound, x2 = 4.2, P ＜ 0.05;and spiral CT, x2 = 6.4, P ＜ 0.05). Conclusion Combined application of high-frequency ultrasound and spiral CT can improve the diagnosis rate of thyroid carcinoma.

OBJECTIVE:To investigate the dosage and consumption sum of opioid analgesic drug in Qingdao district. METH-ODS:The consumption data of drugs in 29 public hospitals at secondary or above level in Qingdao district were analyzed statistical-ly by ABC analytic methods and defined daily dose methods. RESULTS:In ABC analysis,5 kinds of class A drugs accounted for 20% of the total number of species,and the percentage of consumption sum was 77.38%;4 kinds of class B drugs accounted for 16.00% of all species numbers,and the percentage of consumption sum was 11.98%;other 16 kinds of drugs accounted for 64.00% of the total number of species,and the percentage of consumption sum was 10.64%. Oxycodone sustained-release tablets and Morphine sustained-release tablets with the highest DDDs consumed more health care costs,serial number ratio was 1.00,syn-chronization was good and conform to the actual needs of clinical work. CONCLUSIONS:The composition ratio of opioid analge-sic drug costs is consistent with the theoretical value,significant discrepancy between cost and DDDs does not appear.