A 48-year-old middle aged male presented swelling lymph nodes and mass in neck for 5 years. Physical examination shows swollen mass in head and neck regions. The masses could be touched in bilateral parotids and neck with a little movement and moderate tenderness. The level of IgG was normal, but Eosinophi count was high. The function of heart liver and kidney was normal. The result of B-mode ultrasonography reveals bilateral parotids and subcutaneous near parotids were widely swollen and several swollen lymph nodes in neck. pathological examination displays features of a large number of lymph follicles hyperplasia, acidophilic granulocyte infiltration, capillary hyperplasia and fibrosis of different level. The disease were eventually diagnosed by pathological examination. Method of treatment includes glucocorticoid drug therapy, surgical resection and local radiotherapy. The last treatment of patients with Kimura's disease should be combined with the clinical manifestation of them to determine the individualized treatment, so as to improve the quality of life of patients.
Angiolymphoid Hyperplasia with Eosinophilia ; diagnosis ; pathology ; therapy ; Glucocorticoids ; therapeutic use ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Neck ; Parotid Gland ; pathology

This experiment was done to compare the effects of antegrade and retrograde cold cardioplegic solutions on myoeardium in the presence of coronary obstruction. Twelve mongrel dogs were anesthetized with intravenous pentobarbital, and immediately after the left anterior descending of coronary artery (LAD) was tied off, all subjects were randomly allocated to receiving antegrade cardioplegic solution (4 C) through arotic root at initial dose of 20ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 10.7kPa every 20 minutes (group n=6), or antegrade cardioplegic solution in the same way as mentioned above at initial dose of 10ml?kg~(-1) and retrograde cardioplegic solution at initial dose 10ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 5.3kPa every 20 minutes (group Ⅱ, n=6), respectively. The occlusion of LAD lasted 60 minutes. As compared with the values of group Ⅰ, in group Ⅱ, there was a lower hypothermia in the myocardial re gion supplied by LAD during ischemia (P

OBJECTIVE: To explore the clinical feature, the reason of misdiagnosis and mistreatment, influential factor of prognosis in patients with extranodal NK/T cell lymphoma-nasal type. METHOD: A retrospective study was made on the clinical data of 34 patients with extranodal NK/T cell lymphoma-nasal type. Among them, 10 cases were staged I(E) intra-cavity, 15 cases were I(E) ex-cavity, 6 cases were II(E) and 3 cases were IV(E). Among them, 29 cases were in nasal cavity, 5 cases were outside nasal cavity; 14 cases were treated with single chemotherapy or radiation therapy, 20 cases were treated with radiation therapy add chemotherapy. RESULT: The total rate of misdiagnosis and mistreatment were 58.8% (20/34), 52.3% (18/34), respectively. The 5-year survival rate of the I(E) intra-cavity group were 60.0% (6/10), and those of I(E) ex-cavity group were 26.7% (4/15), and those of II(E) group and IV(E) group were 16.7% (1/6), 0% (0/3), respectively There was significant difference between 3 groups by statistical analysis (P < 0.01). The 5-year survival rate of I(E) ex-cavity group treated with single therapy were 0% (0/6), and those of I(E)-cavity group treated with combined therapy were 50% (1/2). CONCLUSION The early clinical manifestation of extranodal NK/T tell lymphoma-nasal type is atypical and which is hard to diagnose and treat. Diagnosis depends on pathologic biopsy and immunohistochemistry, there are many factors that influence the prognosis of this disease, in which the clinical stage is a major factor. It is crucial for diagnosing and treating early.
Adolescent ; Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; therapy ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; therapy ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVE: To investigate the influence of nasal septal deviation on the incidence of bilateral sinusitis. METHOD: Two thousand and seventy-four cases of nasal septal deviation with chronic sinusitis available from January 2006 to March 2012 were reviewed retrospectively. RESULT: Of these 2074 cases, 1 687 (81.3%) patients had sinusitis in narrow side and 1582 (76.3%) in wide side, the difference was statistically significant (P < 0.01) and the relative risk value in narrow side (1.4) was higher than wide side (0.7) associated with the incidence of sinusitis. There was significant difference (P < 0.05) between the two group counting datas analyzed by rank sum test, and the mean rank order in narrow side was 1656.396, significantly greater than wide side (1 612.184). The incidence of sinusitis in men was 50.6% (1049/2074), in women was 49.4% (1025/2074), and there was no significant difference between them. Deviating leftward was 1148 cases (55.4%), deviating rightward was 926 cases (44.6%), and the difference was statistically significant (P < 0.05). Anatomic variations in narrow side and wide side were uncinate process hypertrophy (7.0%, 27.0%), middle turbinate hypertrophy (7.8%,38.0%), ethmoidal bulla hypertrophy (26.2%, 39.0%), paradoxical middle turbinate (5.4%, 15.5%), hypertrophic inferior turbinate (52.9%, 67.0%) and mucosa pachynsis (0.5%, 2.8%), respectively. CONCLUSION Sinusitis incidence in narrow side is higher than wide side. There is no significant difference between the incidence of sinusitis in men and women. The majority of nasal septum deviate leftward. Higher incidence of sinusitis in wide side is the result of compensatory mechanism. Only septoplasty may not restore the normal venting function in nasal cavity. Hypertrophic inferior turbinate are closely correlated with sinusitis.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Nasal Cavity ; Nasal Septum ; abnormalities ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis ; epidemiology ; Turbinates ; abnormalities ; Young Adult

Summary: The regulation of hypoxic response elements on the expression of vascular endothelial growth factor (VEGF) gene transfected to primary cultured rat skeletal myoblasts under hypoxic environment was investigated, pEGFP-C3-9HRE-CMV-VEGF vector was constructed with molecular biology technique and transfected to primary cultured rat skeletal myoblasts by lipofectamine in vitro. Gene expression of transfected myoblasts was detected by RT-PCR, Western blot and fluorescence microscope under different oxygen concentrations and different hypoxia time. The results showed that in hypoxia group, the VEGF gene bands were seen and with the decrease of oxygen concentrations and prolongation of hypoxia time, the expression of VEGF mRNA was obviously increased.Under hypoxic environment, the expression of VEGF protein in the transfected myoblasts was significantly increased. EGFP was expressed only under hypoxic environment but not under normoxic environment. It was concluded that hypoxia promoter could be constructed with HRE and regulate the expression of VEGF gene under hypoxic and normoxic environment, which could enhance the reliability of gene therapy.

OBJECTIVETo compare the difference of intra-abdominal infection between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in patients undergoing laparoscopic right hemicolectomy within postoperative 30 days.

METHODSClinical date of right colon cancer patients undergoing laparoscopic right hemicolectomy at the Department of Colorectal Surgery, PUMCH from January 1st, 2013 to October 31st, 2016 were retrospectively analyzed. Patients with stage IV cancers which could not be radically resected, emergency operation and conversion to open surgery were excluded. The intracorporeal anastomosis and extracorporeal anastomosis were compared in the items of operation time, postoperative infection and postoperative hospital stay.

RESULTSA total of 194 patients were enrolled in the study, including 73 patients with IA and 121 patients with EA. No significant differences were found in gender, age, previous operation history, tumor site and T stage of the tumor between two groups (all P>0.05). There were also no significant differences in mean operative time (162.4 minutes vs. 167.7 minutes, P=0.257), time to first flatus (3.3 days vs. 3.4 days, P=0.744), number of harvested lymph nodes (30.3 nodes vs. 33.8 nodes, P=0.071) and postoperative hospital stay (7 days vs. 7 days, P=0.067) between two groups. The incidence of intra-abdominal infection in patients with IA was significantly higher than that in those with EA [13.7%(10/73) vs. 1.7%(2/121), P=0.001], while the differences of the incidence of wound infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652], respiratory infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652] and urinary tract infection [2.7%(2/73) vs. 0.8%(1/121), P=0.558] were not significant.

CONCLUSIONCompared with EA, IA may increase the risk of intra-abdominal infection in patients undergoing laparoscopic right hemicolectomy.

Objective To explore the safety and cosmetic effect of nipple-sparing modified radical mas tectomy and immediate tissue expander implantation with single circumaereolar incision.Methods 30 patients were enrolled in Peking Union Medical College Hospital between Jan.2014 and Dec.2015.All the patients were categorized according to surgical incision (single circumaereolar incision group vs double incisions group).Data on clinicopathological parameters,average hospital stay,complications and overall cosmetic effect were retrospectively collected.Data was performed with Chi-square test,Fisher exact test and t-test.Statistical significance was defined as P＜0.05.Results 19 patients were enrolled in single circumaereolar incision group,and 11 patients in double incisions group.There was no significant difference for operation duration (P=0.093) and average hospital stay (P=0.339).After follow-up for 19.1 months,ranging from 8 to 31 months,no patients developed seroma or arm lymphedema.There was no statistical significance between the two groups in terms of sensation in nippleaereolar area (P=0.973),bilateral symmetry (P=0.650) and overall cosmesis (P=0.483).Conclusion single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness,reliable oncological safety and decent cosmetic effect.

Objective: To investigate the characteristics of acute myocardial infarction caused by spontaneous coronary artery dissection(SCAD) in young female patients. Methods: In this casecontrolstudy,127 young(≤55 years) female patients with acute myocardial infarction onset within 1 week in Nanjing first hospital, Xuzhou central hospital, affiliated hospital of Xuzhou medical university, and Lianyungang first people's hospital were enrolled between January 2013 and February 2017,and the clinical data were retrospectively analyzed. According to their clinical manifestations and coronary angiography(CAG) results,the patients were divided into coronary atherosclerosis disease(CAD) group(CAG evidenced atherosclerosis, n=83) and SCAD group(CAG detected coronary artery dissection,n=44).The SCAD patients were subdivided into definite group (the results affirmed from intravenous ultrasound or optical coherence tomography, n=21) and probable group (the CAG results highly confirmed to characteristics of SCAD,but no intravenous ultrasound or optical coherence tomography image affirmation,n=23). Then, according to the different treatment strategies, the SCAD patients were subdivided into conservative treatment group(treated with drugs,n=19) and interventional therapy group(treated with percutaneous coronary intervention,n=25). Results: (1)Compared to CAD group, patients in the SCAD group had less risk factors, such as hypertension history (25.0% (11/44) vs. 45.8% (38/83) , P=0.022) and diabetes history (6.8% (3/44) vs. 21.7% (18/83) , P=0.043),and had lower levels of fasting blood glucose (5.34(4.59,5.87) mmol/L vs. 7.12(5.18,8.60)mmol/L, P=0.001),total cholesterol((3.94±1.14) mmol/L vs. (4.91±1.50) mmol/L, P=0.001),triglyceride(1.42 (0.91,1.64) mmol/L vs. 1.89 (1.23,2.45) mmol/L, P=0.005),and low density lipoprotein cholesterol ((2.24±0.91) mmol/L vs. (2.94±1.16) mmol/L, P=0.001),CAG results showed that patients in the SCAD group had more single vessel lesion (88.6% (39/44) vs. 39.8% (33/83) , P=0.001), and their target lesion stenosis was less severe ( (79.2±22.4) % vs. (91.5±12.1) %, P=0.001). (2) The clinical risk factors such as hypertension history, diabetes history, smoking history, family history of cardiology disease, fasting blood glucose,total cholesterol,triglyceride and low density lipoprotein cholesterol were similar between definite group and probable group (all P>0.05). CAG results showed that prevalence of single vessel lesion (100% (21/21) vs. 78.3% (18/23) , P=0.050) and percent of target lesion stenosis ( (76.9±20.6) % vs. (81.2±24.1) %, P=0.529) were similar between definite group and probable group.(3)There were no significant difference in single vessel(84.0% (21/25) vs. 94.7% (18/19) , P=0.370), target lesion stenosis(85.0(70.0,100.0)% vs. 75.0(50.0,90.0)%, P=0.186),and survival rates in hospital(96.0% (24/25) vs. 100% (19/19) , P=1.000) between interventional therapy group and conservative treatment group. Conclusions Prevalence of SCAD is highin young female patients with acute myocardial infarction. Acute myocardial infarction patients with less risk factors of CAD and with CAG showing smooth lesion of narrowing segment and normal finding in the other vessels, are more likely to be diagnosed with SCAD.Acute myocardial infarction patients caused by SCAD have high survival rate either receiving percutaneous coronary intervention or drug treatment.

At present, fatigue state monitoring of upper limb movement generally relies solely on surface electromyographic signal (sEMG) to identify and classify fatigue, resulting in unstable results and certain limitations. This paper introduces the sEMG signal recognition and motion capture technology into the fatigue state monitoring process and proposes a fatigue analysis method combining an improved EMG fatigue threshold algorithm and biomechanical analysis. In this study, the right upper limb load elbow flexion test was used to simultaneously collect the biceps brachii sEMG signal and upper limb motion capture data, and at the same time the Borg Fatigue Subjective and Self-awareness Scale were used to record the fatigue feelings of the subjects. Then, the fatigue analysis method combining the EMG fatigue threshold algorithm and the biomechanical analysis was combined with four single types: mean power frequency (MPF), spectral moments ratio (SMR), fuzzy approximate entropy (fApEn) and Lempel-Ziv complexity (LZC). The test results of the evaluation index fatigue evaluation method were compared. The test results show that the method in this paper has a recognition rate of 98.6% for the overall fatigue state and 97%, 100%, and 99% for the three states of ease, transition and fatigue, which are more advantageous than other methods. The research results of this paper prove that the method in this paper can effectively prevent secondary injury caused by overtraining during upper limb exercises, and is of great significance for fatigue monitoring.
Electromyography/methods* ; Fatigue ; Humans ; Muscle Fatigue ; Muscle, Skeletal ; Upper Extremity

Objective: To improve the accuracy of diagnosis and to reduce the misdiagnosis rate of nasopharyngeal carcinoma by analyzing the characteristics of such masses. Methods: Clinical data from 55 patients with suspicion of nasopharyngeal carcinoma diagnosed and treated between March 2016 and September 2017 were analyzed. All patients were followed up regularly. Results: With following-up of 12 to 25 months, 6 (10.9%) of 55 cases were identified as nasopharyngeal malignant tumors, including 4 cases of nasopharyngeal carcinoma and 2 cases of lymphoma, and 49 cases (89.1%) were diagnosed with nasopharyngeal benign masses, including 29 (59.2%) cases for nasopharyngeal lymphoid proliferation, 15 (30.6%) for adenoid hypertrophy, 2 (4.1%) for nasopharyngeal cyst, 1 (2.0%) for polyp, 1 for papilloma and 1 for nasopharyngeal pharyngeal cyst. Small nasopharyngeal malignant tumor and masses with benign hyperplasia showed the overlap of images on the enhanced MRI/CT and Fibro-nasopharyngoscopy, but all 6 patients with nasopharyngeal malignant tumors presented with moderately enhanced multiple enlarged lymph nodes. Conclusions Fibro-nasopharyngoscopy and enhanced MRI/CT have some value on evaluation of nasopharyngeal masses, but biopsy is a golden standard for diagnosis. Follow-up is necessary for the patients with negative biopsy and benign nasopharyngeal hyperplasia indicated by fibro-nasopharyngoscopy and enhanced MRI/CT.