Purpose To evaluate the application value of rapid exchange method in transnasal intestinal obstruction catheterization. Materials and Methods Fifty-eight patients with adhesive intestinal obstruction underwent transnasal catheterization under X-ray fluoroscopy, of which 31 cases were treated with rapid exchange catheterization method (group A) and the other 27 cases with traditional catheterization method (group B), success rate, operation time and complications were compared between the two groups. Results Catheterization success rate of group A and group B were 96.77%(30/31) and 77.78%(21/27) respectively, which was significantly higher in group A than in group B (χ2=4.907, P<0.05);operation time of group A and group B were (28.2±12.3) min and (25.4±15.7) min respectively, and the difference between them was not statistically significant (t=1.219, P>0.05); no operation associated injury occurred in group A and only one case in group B (3.70%) resulted in bilateral nasal edema with a small amount of bleeding because the operating time was too long, complication rate between the two groups was also not statistically significant (P>0.05). Conclusion Rapid exchange method can improve the success rate of transnasal intestinal obstruction catheterization, but the operation time and complications are comparative to those of the conventional method.

Objective To study the effect of anti-hypertensive therapy on the characteristics of platelet in essential hypertension(EH) patients. Methods Thirty-two healthy people(CT) and 37 patients with primary hypertension (gradeⅠ) were recruited . Blood pressure and 4 platelet parameters: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet hematocrit (PCT) were determined by whole blood automatic analysis apparatus. Results The 4 platelet parameters were increased in hypertension patients compared with healthy people and decreased after anti-hypertensive therapy[PLT:(before 201.8?72.9 vs after 187.1?68.6 )10~ 9 L+{-1}; MPV:(before 10.3?1.9 vs after 10.0?1.9)fL, PDW:(before 15.5?1.1 vs after 15.2?1.0)fL; PCT:(before 0.198%?0.047% vs after 0.187%?0.036%)](P

Objective To explore the reasons of biliary restenosis after interventional treatment for malignant obstructive jaundice caused by hepatic hilar cholangiocarcinoma and to discuss its management. Methods During the period from June 2010 to Sep. 2013 at authors’ hospital, a total of 36 patients with high biliary obstruction caused by Bismuth Ⅱ - Ⅳ type of hepatic hilar cholangiocarcinoma received percutaneous transhepatic cholangial stenting (PTCS), and as the patients developed biliary restenosis after PTCS percutaneous transhepatic cholangial drainage (PTCD) had to be carried out. All the patients had complete data. Serum total bilirubin, direct bilirubin, glutamyltranspetidase and alkaline phosphatase levels were determined on the operation day and at five days after PTCS and PTCD. The short - term remission of malignant obstructive jaundice produced by PTCS and PTCD were assessed. The causes of biliary restenosis were analyzed by comparing the CT and/or MRI images as well as the cholangiography and drainage test results which were performed at the first and second admission to hospital. Results The interval time from operation to restenosis was 31 - 468 days, with an average of 132.8 days. The effective rates of PTCS and PTCD for relieving jaundice were 77.8% and 75.0% respectively. The main causes of restenosis included the formation of biliary sludge, acute cholangitis and tumor growth. Conclusion PTCS is an effective means to relieve the malignant obstructive jaundice caused by hepatic hilar cholangiocarcinoma, however, the incidence of biliary restenosis after PTCS is higher, which may be mainly due to the tumor growth. Nevertheless, subsequent PTCD can effectively improve the liver function, control biliary infection, remit biliary obstruction and relieve the clinical symptoms.

Objective To evaluate superselective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma.Methods Superselective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out.The clinical data,including the volume of blood loss during the surgery,the operative time and the complications,were retrospectively analyzed.Results Superselective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days.The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes.Mild complications occurred in 6 patients after embolization,which were subsided after symptomatic management.No serious complications occurred after surgical resection.The mean hospitalization days of the patients were 3.5 days.Conclusion Preoperative superselective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection,apparently shorten the operative time and effectively lower the occurrence of complication after the operation.Superselective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma.

We report a case of primary sinonasal tuberculosis in a 23-year old man. He had a half-year history of headache and eye pain on the left side, and found the neoplasm of nasopharynx 15 days ago. Previously denied history of tuberculosis and contact history. After be admitted to hospital, twice biopsy from neoplasm of na- sopharynx were both of chronic inflammation. Coronal CT scan of the lesion when admission found the left parasellar region and the left sphenoid sinus soft tissue density increased, about 20 mm X 32 mm X 34 mm, left inferior wall between sella bone defects, and bone sclerosis, plain CT value was about 34 HU, the lesion protruded downward left the nasopharynx. Eight days after he was admissioned in hospital of sphenoid sinus biopsy showed granulomatous inflammation and tuberculosis diagnosis was considered. Review of the lesion is partial absorbed after 11 months of anti-tuberculosis treatment and now is still in follow-up.
Biopsy ; Headache ; Humans ; Male ; Sphenoid Sinus ; microbiology ; pathology ; Tomography, X-Ray Computed ; Tuberculosis ; diagnosis ; Young Adult

〔Abstract〕 In the paper , the status quo of mobile medical service is analyzed , proving a new mode of mobile medical service for pa-tients.The suggested functions like self -service information query and medical service guiding as well as solutions to the relevant system structure and information security are elaborated in detail .In addition, the feasibility of construction of applications for mobile medical di-agnosis and treatment is also discussed .

BACKGROUND:With respect to mesenchymal stem cels from other sources, synovial mesenchymal stem cels are rich in source, and moreover, the synovial tissue can regenerate quickly after partial hepatectomy and lead to fewer complications, in recent year, which have become a hot spot in stem cel research. OBJECTIVE:To observe the proliferation and directional differentiation of synovial mesenchymal stem cels from osteoarthritis patients. METHODS:Synovial mesenchymal stem cels were isolated and cultured. MTT assay was used to detect cel proliferation ability. Alkaline phosphatase activity was detected quantitatively at 7 days of osteogenic induction, and osteogensis-related gene expression was measured at 7, 14, 21 days of osteogenic induction. Alizarin red staining was performed at 21 days of induction. RESULTS AND CONCLUSION:(1) Passage 3 synovial mesenchymal stem cels proliferated faster, which were in latent period at 1, 2 days after inoculation, in logarithmic growth phase at 3-6 days, and then entered into the plateau phase at 7 days. (2) The activity of alkaline phosphatase was significantly higher in the induction group than the control group at 3, 7, 10 days after osteogenic induction (P < 0.05). The cels were positive for alizarin red staining at 21 days of osteogenic induction, and there were calcium deposits and calcium nodules in the extracelular matrix. (3) Bone-binding protein and Runx2 were visible at 7 days of osteogenic induction, and reached the peak at 21 days. These findings indicate that synovial mesenchymal stem cels from patients with advanced osteoarthritis have strong proliferation ability, which can differentiate into osteoblasts under in vitro induction.

BACKGROUND:Trauma easily leads to the emergence of articular cartilage defects, which is a difficult problem in the orthopedics field. Tissue engineering technology provides a new method for cartilage repair. OBJECTIVE:To explore the feasibility of combining chitosan and bone marrow mesenchymal stem cels to repair injured articular cartilage in rabbits. METHODS: Cultured rabbit bone marrow mesenchymal stem cels were seeded onto chitosan scaffold, and then the composite material was implanted into the defect as experimental group. Rabbits with no treatment served as control group. Gross observation and toluidine blue staining were carried out at 6 and 12 weeks after operation. RESULTS AND CONCLUSION:At 6 weeks after operation, the control group had only fibrous tissue hyperplasia, and in the experimental group, cartilage-like tissues were generated at the defect site. At 12 weeks after operation, a smal amount of hyaline cartilage-like tissues were observed in the control group, and the defects in the experimental group were covered with smooth and hyaline cartilage tissues. After 12 weeks, the toluidine blue staining was light in the control group with a smal amount of cartilage tissues; in the experimental group, the toluidine blue staining was remarkable, and the defects were completely covered with hyaline cartilage tissues, and cartilage cels were increased in number. The findings indicate that chitosan-bone marrow mesenchymal stem cels composite material is better to induce cartilage tissue formation and promote cartilage defect repair.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) with scissors knife in difficult cases.Methods A total of 36 sessions of ESD in 34 patients were performed from May 2010 to May 2012 with application of new scissors knife.The complications and followup outcomes were recorded.Results All lesions were removed successfully with an en bloc resection rate at 91.7％.Delayed bleeding occurred in 2 patients (5.6％),and both of them were cured sucessfully with endoscopy.No perforation happened and the average hospitalization time was 5 days.Follow-up endoscopy performed 6 or 12 months after ESD in 6 patients revealed no recurrence or residual lesions.Other patients are under follow-up now.Conclusion The scissors knife is easy to manipulate,which can ensure the safety and efficiency of ESD.

Objective To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion.Methods Seventeen patients [13 males,4 females ; (56 ± 11)years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization,balloon angioplasty and stenting via femoral or brachial artery route.Cerebral protection devices were used in 6 cases to avoid cerebral embolism.Results Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100％ technical success rate) and in other 8 cases with subclavian artery occlusion (88.9％ technical success rate).Five cases were treated with balloon angioplasty,and 11 cases were treated with balloon angioplasty combined with stenting.Good patency was seen in the 16 cases immediately after the procedure.The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved suceessfully.Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months].Restenosis was found in one case 10 months later and was successfully treated with re-PTA.One case with aortoarteritis died of cerebral infarction 18 months later.No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency.Conclusions Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion.