Objective To study the expressions of matrix metalloproteinase-2(MMP-2)and vascular endothelial growth factor (VEGF)in laryngeal carcinoma and their clinicopathological significance.Methods The immuno-histochemical technique was used to detect the expression staining results of MMP-2 and VEGF in 54 cases of laryngeal carcinoma,23 cases of polyps of vocal cord and 1 5 cases of normal laryngeal mucous tissues verified by clinicopathology under the automatic image analyzer.Results The ex-pression rates of MMP-2 and VEGF were 72.22%(39/54)and 70.37%(38/54)in the laryngeal carcinoma tissue,which were sig-nificantly higher than 47.83% and 39.13% in polyps of vocal cord and 40.00% and 46.67% in the normal laryngeal tissues respec-tively,the differences between them had statistical significance(P<0.05).The expressions of MMP-2 and VEGF had certain corre-lation with the clinical stage,lymph node metastasis and.infiltration depth of laryngeal carcinoma.Conclusion MMP-2 and VEGF may jointly participate in the process of infiltration and metastasis in laryngeal and have certain relation with the tumorous invasive growth.

005) The prevalence of Hp infection in antrum was significantly lower in patients with GERD (16/50) and BE (33/106) than that in control subjects (30/50,P

Objective To evaluate the value of double vital staining with both iodine and methylene blue in diagnosing early esophageal carcinoma. Methods Lugol' s iodine was sprayed on the esophageal lesions first, then methylene blue. The results before or after staining with mythylene blue were compared. The tumor infiltrative depth in the esophagus was assessed by gastric endoscopy and endoscopic ultrasonography (EUS). The tumors were resected surgically or under endoscopy. Results After Lugol's iodine spray it stained the normal esophageal squamous epithelium brown-black, whereas the lesions did not. In 10 cases with 11 lesions, 9 cases (81. 8% ) showed the margin of lesions fairly clear. After spray of methylene blue it stained all the lesions in blue color with clear margin. The mucosal resection was done in one case under endoscopy and surgical resection in 8 cases. All of the 9 cases were diagnosed pathologically squamus carcinoma including mucosal carcinoma, 6 lesions and submucosal carcinoma, 4 lesions. The pathological diagnostic accuracy in differentiating mucosal cancer from submucosal cancer by endoscopy or EUS was 80% ; by both endoscopy and EUS in conjunction was 90%. Conclusion Double vital staining with both iodine and methylene blue is very useful in revealing the area and infiltrative depth of early esophageal cancer.

Objective To study the mechanism of cisapride in the treatment of gastricelectric dysrhythmia. Methods Cisarpride was gavage fed to rats in which gastricelectric dysrhythmia hed been reproduced. The cholinergic and nitriergic nerves in myenteric plexus of gastric antrum were examined with histochemical staining methods and whole mount preparation technique. The levels of cAMP and cGMP in the antral smooth muscle were measured by radioimmunoassay. Results Gastricelectric dysrhythmia in the model group was ameliorated after the treatment with cisapride(P

ObjectiveTo investigate the mechanism for the curative effect of douching with nasal sinuses perfusate in treating chronic sinusitis after endoscopic sinus surgery.MethodsSeventy-six chronic sinusitis patients after endoscopic sinus surgery were divided into treatment group and control group by random digits table with 38 cases each.Every group was given postoperatively sinus flush,treatment group was flushed with nasal sinuses perfusate,while contro group was flushed with 0.9％ sodium chloride.Therapeutic effect was evaluated after two months.The therapeutic effects of the two groups were compared and the inflammation factor levels and changes of sinus mucosa were observed before and after treatment.ResultsIn treatment group,there were 21 cases to be cured,13 cases to be improved,4 cases to be useless,the total effective rate was 89.5％(34/38),while in control group,there were 12 cases to be cured,15 cases to be improved,11 cases to be useless,the total effective rate was 71.1％(27/38),the total effective rates between two groups were statistically significant(P ＜0.05).The levels of interferon (IFN)-γ,interleukin(IL)-2,IL-4,IL-5 after treatment in treatment group were respectively ( 13.21 ± 1.38),( 14.59 ±1.43 ),(34.83 ± 5.31 ),( 39.93 ± 7.98 ) pg/L,which were significantly decreased compared with those before treatment [ (23.87 ± 1.76),( 16.13 ± 1.71 ),(67.37 ± 7.36),(81.82 ± 7.69) pg/L,P ＜ 0.05 ].The levels of IFN- γ,IL-2,IL-4,IL-5 after treatment in control group were respectively (20.13 ± 2.73 ),( 14.82 ± 2.26),(48.92 ±7.62),(43.87 ±8.25) pg/L,which were significantly decreased compared with those before treatment [ (24.06 ± 1.82 ),( 15.96 ± 1.74),(66.81 ± 8.24),(82.16 ± 7.34) pg/L,P ＜ 0.05 ].And the levels of IFN- γ,IL-4,IL-5 after treatment in treatment group were significantly lower than those in control group,the differences were statistically significant(P ＜ 0.05).ConclusionsThat nasal flush with nasal sinuses perfusate for postoperative patients with chronic sinusitis after endoscopic sinus surgery may improve the therapeutic effect and nasal sinuses perfusate formula is superior to 0.9％ sodium chloride alone,and the mechanism may be related to inhibition of inflammation factor release of sinus mucosa.

Objective To evaluate the clinical application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in diagnosis of mitral valve prolapse(MVP).Methods Twenty patients with MVP with more than moderate mitral regurgitation referred for mitral valve repair (MVR) were studied.All patients underwent RT-3D-TEE and mitral valve quantification(MVQ) before MVR.The location of scallop lesions and ruptured mitral chordae tendineae for mitral valve were evaluated,and compared with surgical findings.Carpentier's nomenclature was applied to the mitral valve anatomic localization either RT-3D-TEE or surgery.There were three anterior leaflet scallops defined as A1,A2 and A3,and three posterior leaflet scallops defined as P1,P2 and P3.Results ① The shape and spatial structure of the scallop lesions and ruptured mitral chordae tendineae of mitral valve were clearly displayed by RT-3D-TEE,also could be observed through left atrium view and left ventricular view.② Compaired with surgical findings,RT-3D-TEE was of high sensitivity (100 ％),higher specificity (95.46 ％) and crude agreement (95.83％) in the location of P2,the positive likelihood ratio of location of P2 (22.03) was the biggest,the negative likelihood ratio (0) was the smallest.③ RT-3D-TEE had lower sensitivity (66.67％),specificity (83.76 ％) and crude agreement (83.33 ％) in the diagnosis of location of P1 than other locations,the positive likelihood ratio(4.11) was the smallest,the negative likelihood ratio (0.40) was the biggest.④ The sensitivity,specificity,crude agreement,positive likelihood ratio and negative likelihood ratio of RT-3D-TEE in diagnosis of ruptured mitral chordae tendineae accompanied by MVP were 100％,91.67％,95.00％,12.00,0 respectively.Conclusions RT-3D-TEE could clearly display the three-dimensional structure of the lesions of mitral valve.It was of better accuracy in diagnosis of the location of scallop lesions of mitral valve and the rupture of chordae tendineae,and was of important clinical application value in MVR.

Objective To investigate the effect of mucolytic agents during endoscopic sinus surgery.Methods 84 patients of chronic rhinosinusitis were employed in the study,which were randomly divided into the control group(41 subjects) and study group(43 subjects) according to the digital table.The patients in the control group adopted regular therapies,and study group were received regular therapies as well as mucolytic agents(eucalyptol-limonene-pinene soft capsule,300 mg,three times a day) application for 8 weeks.Followed visiting lasted for 6 months.The VAS scores,Lund-Mackay scores and efficient rate were compared.Results The VAS scores and Lund -Mackay scores in the control group after treatment were (3.63 ± 1.71)points and (8.34 ±4.68) points,and which in study group were (2.03 ± 1.67) points and (6.48 ± 3.59) points,and the difference was statistic significant (t =4.338 and t =2.049,P ＜ 0.05).According to CPOS-2012,in the control group,19 cases were controlled,14 cases were partly controlled,and 8 cases were uncontrolled,the whole efficient rate was 80.5％.in the study group,24 cases were controlled,17 cases were partly controlled,and 2 cases were uncontrolled,the whole efficient rate was 95.3％.Compared to the control group,the efficient rate of the study group was higher,the result showed statistical significance (x2 =4.420,P ＜ 0.05).Conclusion Using mucolytic agent after surgery can improve the controlled rate and affect the success of treatment of chronic rhinosinusitis.

BACKGROUND: Peritonitis is the common detective complications at the end-stage of renal failure patients during continuous ambulatory peritoneal dialysis (CAPD) treatment, which easily repeatedly occurred if not handled properly. Although the plumbing designs of peritoneal dialysis have done a lot of effort and improved in recent years, it still hard to avoid. OBJECTIVE: To explore the relative factors and treatments of infectious peritonitis complicated with CAPD. METHODS: Totally 115 cases received CAPD were selected, including 55 males and 60 females, aged (56.2?.7) years. 68 cases of which were suffered infectious peritonitis, aged (58.5?.3) years. All received a (30.3?.5)-month CAPD treatment. The relative factors such as the nutrition situation, whether complicated with diabetes mellitus or not, culture background, domestic environment, whether operating by special person and so on were investigated, and the relationship between those factors and infectious peritonitis were analyzed. The pathogen method was used to check pathogenic bacteria, and those patients were treated with irrigation of abdominal cavity and antibiotics in two ways, that is, systemic and intra-abdominalcavity. Hemodialysis instead of CAPD was used in those infectious peritonitis patients.RESULTS AND CONCLUSION: Those patients with good nutrition situation, higher culture background, better domestic environment, and operating by special person had low chances to infect peritonitis. And those patients with diabetes mellitus had high chances to infect peritonitis. Treatments of abdominal cavity and anti-infection in two ways-systemic and intra-abdominal cavities were effective to those infectious peritonitis patients. Gram-positive bacteria were the most common pathogen, which were susceptive to vancomycin and cefazolin. If the pathogen was gram-negative bacteria, etimicin sulfate, amikacin, and imipenem cilastatin could be selected. Infectious peritonitis complicated with CAPD affected by many factors. CAPD patients should be provided better nutrition and domestic situation. Also patients should operate in aseptic ways. Doctors should choose proper patients who can operate CAPD right.

Objective To investigate the therapeutic effect of lengthening and rotational osteotomy of the fibula for lateral malleolar malunion. Methods Twenty-three patients who had suffering from the traumatic arthritis of ankle were due to lateral malleolar malunion treated with lengthening and rotational osteotomy from October 2005 to July 2008. Special radiographs were use to fully detect the extent of shortening and rotation of the fibula. The Lengthening and rotational osteotomy could be conducted with a special compression/distraction device and bone graft. The function of the ankles was evaluated by the American Orthopedic Foot Ankle Society (AOFAS) scoring system. Serial radiographs of the ankle were made to assess the bone healing and changes of posttraumatic osteoarthritis. Results Seventeen of 23 patients were followed up, with a mean 29.1 months (12-45 months). All the fractures were healed. The mean bone healing time was 13.3 weeks (11-16 weeks) and the mean time of total weight-bearing was 12.1 weeks (11-15 weeks). The ankle function score had improved from 29 (21-47) preoperatively to 81 (56-91)12 months after the operation. There was 5 in excellent, 8 in good, 3 in mild, 1 in poor, and the rate of good outcomes was 76.5%. After the operation, 1 patient had a skin necrosis around the wound which healed by conservative treatment. A slightly aggravated degeneration of the ankle joint was seen in 2 patients who responded to conservative managements. No failure of the internal fixation was noted in this group. Conclusion The outcomes demonstrate that reconstructive lengthening osteotomy is well worthwhile when there is absent or minimal osteoarthritic change, regardless the time from the original injury. Lengthening of the fibula is an important step in the treatment of the painful ankle when the fibula become shorter after injury, even when degenerative changes of the joint are already present. The lengthening of the fibula could lead to a good outcome in ankle with lateral malleolar malunion.

Objective To investigate the MR imaging findings of acute experimental allergic encephalomyelitis(EAE) in correlation with pathology. Methods An EAE model was induced by intradermal inoculation with guinea pig CNS homogenate in 6 female Lewis rats.Another 6 rats served as control.The clinical presentation and body weight of the animals were recorded daily. Routine MRI,Gd-enhanced MRI were performed when EAE animals showed the initial symptoms. Uhrasmall superparamagnetic iron oxide(USPIO) colloid solution was also administrated intravenously and MRI was performed again after 24 hours. The brain was removed instantly after the second MR imaging. The pathological exams including HE staining,myelin sheath staining and prussian staining were performed.The imaging findings were observed in correlation with pathological results. Results The EAE rats showed decrease of body weight on the 6th to 7th day after inoculation,and the clinical symptoms appeared on the 10th to 11th day after inoculation.Routine MRI did not show any definite abnormalities.The Gd-enhanced MRI found the diffuse thickening and enhancement of brain meninges.The USPIO-enhanced MRI showedareas of low signal intensity at white matter of medulla oblongata on T2WI,and high signal intensity was observed at the corresponding area on T1 WI. Gradient T2 * WI found more foci of low signal intensity in eerebellar white matter besides the lesions in the brain stem.The range of abnormal signal intensity was larger in animal with higher clinical scores than that with lower score.There were no abnormal findings in control animaL The pathological exam found "perivascular cuff" in the brain white matter in EAE animals,some accompanied with adjacent demyelinatian. The prussian staining found blue particles within the cytoplasm of the macrophages around the lesion,which corresponded to the area of low signal intensity on T2WI.Conclusion USPIO-enhanced MRI could reveal acute EAE lesions which were not capable of being shown on routine MRI and Gd-enhanced MRI.It can image the macrophages around the lesions in vivo.USPIO is important for future research and application in MS patients.