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.

Current hospital information system has to be reconstructed to satisfy futural requirements. The reconstruction improves the network structure, network performance, bandwidth, manageability and safety of current system, and makes it reliable and expandable.

Objective To describe the application situation, existent problems and insufficiencies of the electronic medical record (EMR) based on XML, and discuss the future development and requirement of EMR. Methods In recent three years, the application practice and current development condition of EMR based on XML were summarized. Results The EMR based on XML was provided considerable convenience and advantage for writing of medical record and the monitor of medical quality. Conclusion The electronic medical records are an important part of client information system (CIS), has become a necessary part of hospital informationization, and its extensive application has a long way to go.

OBJECTIVETo explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.

METHODSClinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively. Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.

RESULTSThe sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5%, 81.5% and 98.9%, 61.3%, respectively. The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement, while the difference was not statistically significant (84.5% vs. 77.2%, P=0.060). The rates of serosal invasion of normal type, reactive type, nodular type, tendonoid type and color-diffused type were 0 (0/29), 2.5% (1/40), 40.5% (15/37), 59.2% (29/49), and 82.4% (42/51) respectively. The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement, and the difference was statistically significant (61.2% vs. 87.8%, P=0.002).

CONCLUSIONSMultidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer. For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance, surgeons should pay attention to the value of preoperative CT findings.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intraoperative Care ; Male ; Middle Aged ; Neoplasm Invasiveness ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Serous Membrane ; diagnostic imaging ; pathology ; Stomach Neoplasms ; diagnostic imaging ; pathology ; Tomography, Spiral Computed ; methods

ObjectiveTo investigate the association of nonalcoholic fatty liver disease (NAFLD) with insulin resistance and dyslipidemia in patients with type 2 diabetes mellitus,and to analyze the risk factors.Methods A total of 200 patients with type 2 diabetes mellitus including 99 with NAFLD and 101 without NAFLD were recruited.Height,weight,waist circumference,hip circumference,liver enzymes,blood lipids,fasting and postprandial blood glucose,insulin,C-peptide,and HbA1C levels were detected.Body mass index ( BMI),waist-hip ratio( WHR),and improved insulin and C-peptide index(HOMA-C-peptide) were calculated and compared between two groups.ResultsCompared with non-NAFLD group,weight,BMI,waist circumference,hip circumference,alanine aminotransferase ( ALT),aspartate aminotransferase,triglyceride ( TG ),total cholesterol ( TC ),low density lipoprotein-cholesterol(LDL-C) were significantly higher in NAFLD group( all P＜0.01 ),while age,duration,and high density lipoprotein-cholesterol were lower( all P＜0.05 ).The incidence of combined hyperlipidemia,especially hypertriglyceridemia,was significantly higher in NAFLD group( P＜0.01 ).Fasting and postprandial 1 h blood glucose [ ( 2.07 ±0.36 vs 1.83 ±0.43 ) mmol/L,( 14.04 ± 3.96 vs 12.59 ± 3.90 ) mmol/L ],fasting and postprandial 1 h Cpeptide [ (2.79± 1.15 vs 2.08±1.29 ) ng/ml,( 1.33 ±0.45 vs 1.12±0.54) ng/ml ],HbA1C [ (2.09±0.33 vs 1.96±0.28) ％ ],and HOMA-C-peptide index were significantly increased in NAFLD group ( P ＜ 0.05 or P ＜ 0.01 ).Logistic analysis showed that TG,BMI,and ALT were the major risk factors of NAFLD in type 2 diabetes mellitus( P＜0.05 or P＜0.01 ).ConclusionTriglyceridemia,obesity,and raised ALT level were significantly associated with an increased risk of NAFLD in patients with type 2 diabetes mellitus.

Objective:The purpose of this study is to investigate the expression of tumor stem cell marker aldehyde dehydrogE-nase 1 (ALDH1) in breast cancer and its clinical significance. Methods:The expression of ALDH1 protein was examined by immunohistochemical staining in 92 breast cancer tissues. The correlation analysis and diseasE-free survival analysis of patients was evaluated based on the clinical follow-up data. Results:Expression of ALDH1 protein had a significant correlation with progesterone receptor (PR) and cerb-B2 (P<0.05), but had no significant correlation with age, tumor size, clinical staging, and lymph node metastasis (P>0.05). The 2-year diseasE-free survival rate of AlDH1-positive patients was lower than that of ALDH1-negative patients (P<0.05). ALDH1-positive patients, who received CEF regimen chemotherapy and hormone therapy, had lower 2-year diseasE-free survival rate than that of ALDH1-negative patients (P<0.05). Conclusion:The decreased diseasE-free survival rate of ALDH1-positive patients is related with drug resistance. ALDH1 could be used as an independent factor for predicting the prognosis of breast cancer.

Objective To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) on plasma visceral adipose tissue-derived serine protease inhibitor ( vaspin ) levels in patients with recentonset type 2 diabetes mellitus, and to study the association between insulin sensitivity and vaspin levels.Methods Thirty patients with recent-onset type 2 diabetes mellitus were treated with CSII for 2 weeks.Euglycemic-hyperinsulinemic clamps (EHC) were performed to evaluate the insulin sensitivity in type 2 diabetes group. Plasma vaspin levels were measured by an ELISA kit. The association between plasma vaspin levels and metabolic parameters were analyzed. Results Fasting plasma vaspin levels were higher in type 2 diabetes than in impaired glucose regulation and normal glucose tolerance groups [( 1.83±0.55 vs 0. 43±0.21 and 0.56±0.26) ng/ml,P＜0.05]. With CSII,vaspin levels [( 1.19 ±0.57 vs 1.83 ±0.55 ) ng/ml, P＜0.05] and homeostasis model assessment for insulin resistance [HOMA-IR ,2.30 ( 1.09-7.2 ) vs 4.28 ( 1.7-6.47 ), P＜0.05] were significantly decreased,accompanied with an increase in glucose metabolic rate [(5. 10±0.51 vs 2.99±0.42 )mg·kg-1·min-1 ,P＜0.05] in type 2 diabetes group. Changes in circulating vaspin concentrations were correlated positively with changes in HOMA-IR. Conclusion In type 2 diabetic patients,elevated plasma vaspin levels are significantly decreased after CSII treatment. Vaspin may play a role in improving insulin sensitivity of diabetic humans.

To study the inhibitory effect of RNA interference (RNAi) on MMP-9 gene expression in THP-1 cell line.To investigate the application of RNAi on the therapy of leukemia.Methods:Small interfering RNA ( siRNA) for MMP-9 gene was designed and transfected into THP-1 cells.MMP-9 mRNA expression was assessed by RT-PCR, and MMP-9 protein expression was tested by Western blot.MTT and trypan blue staining were used to observe the effect on the proliferation of THP-1 cells after RNAi.The changes in cell morphology were observed under the microscope.Results:The expressions of MMP-9 mRNA and protein were inhibited in THP-1 MMP-9 siRNA-transfected cells ,significantly lower than those of control cells.The results of MTT and trypan blue staining in-dicated that the proliferation ability of THP-1 cells obviously decreased after siRNA-transfected 48h and 72h.The growth of cells was in-hibited and the cells survival rate was significantly lower than that of control group ( P<0.05 ).The cells of control groups grew semi-quote wall under inverted microscope.The outline of cells was clear and the shape was uniform.The cells grew vigorously.While the growth of cells in siRNA group was inhibited.The morphology of siRNA group cells changed obviously by the Wright staining.Most cells expressed changes of apoptosis.Conclusion: siRNA for MMP-9 gene can not only reduce the expressions of MMP-9 mRNA and protein,but also inhibit the proliferation and induce apoptosis of THP-1 cells.

Objective To observe quantitatively the optic radiation alterations in chronic Leber's hereditary optic neuropathy (LHON) using MR diffusion tensor imaging at 3.0 T.Methods Twenty-five patients with chronic LHON and twenty-eight sex-and age-matched disease-free control subjects wereenrolled from March 2011 to December 2014.The whole brain DTI examination and retinal opticalcoherence tomography were performed in all the subjects.The parameters values of optic radiation includingfractional anisotropy(FA),mean diffusivity(MD),principal eigenvalue(λ//),orthogonal eigenvalue(λ⊥) and average retinal nerve fiber layer (RNFL) thickness and temporal retinal nerve fiber layer(RNFL) thickness were measured.For DTI and OCT parameters,differences between patients and controls and differences right and left of the patient group were evaluated using independent-samples t test and paired t test respectively.Results In LHON patients,the DEC maps showed that the bilateral optic radiation fibers were obviously sparse and slender.The values of FA,MD,λ// and λ⊥ in the right optic radiation were 0.523±0.050,(0.903±0.061) × 10-9 mm2/s,(4.999 ±-0.097) × 10-9 mm2/s and (4.126-± 0.065) × 10-9 mm2/s respectively,and the corresponding values of left optic radiation were 0.537±0.041,(1.057±0.573)× 10-9 mm2/s,(5.052±0.119)×10-9 mm2/s and (4.138±0.072)×1009 mm2/s.Compared with optic radiation in the control group,the bilateral FA was significant reduced,the bilateral λ⊥ value and right MD value were significant increased (t=-6.524,-6.045,6.932,6.454,3.471,P＜0.05).However,there were no significant difference of the bilateral λ〃 and left MD (t=-0.457,1.221,1.833,P＞0.05).There were no significant differences in FA,MD,λ//and λ⊥ between the left and right eyes in LHON patients(P＞0.05).The values of average RNFL thickness and temporal RNFL thickness in right eyes were (59.36± 10.94) and (41.72±9.43) μm respectively,and the corresponding values of left eyes were (60.12±9.81),(44.72±9.43) μm.The average and temporal RNFL thickness were significantly thinned in LHON patients compared with the control group(t=-16.357,-10.398,-17.169,-9.672,P＜0.05).There was no significant difference in average RNFL thickness between the left and right eyes (t=0.959,P＞0.05),temporal RNFL thickness between the left and right eyes was statistically significant (t=2.645,P＜0.05).Conclusion The bilateral optic radiation had significant degeneration and atrophy in chronic LHON.

Objective To evaluate the value of serum uric acid(UA)levels with reference to the age,waist circumference,and body mass index(BMI)in predicting the metabolic syndrome(MS)in obese children.Methods A total of 300 obese children,including 180 boys and 120 girls,were enrolled in this study.The height,BMI,waist and hip circumference,blood pressure,serum glucose,insulin and lipid profile in all participants were measured.Oral glucose tolerance test and insulin releasing test were performed.The boys or girls were divided into 4 groups according to the 4 quantile of UA level,respectively.The clinical characteristics and correlation of UA with the clinical indexes and MS components were compared.The binary Logistic regression analysis was applied in the risk of MS and its components for the 4 groups of obese children.The area under the receiver operating characteristic curve(ROC curve)of UA level,age,waist circumference and BMI were used to predict the MS.Results UA level was increased with the increase of age,waist circumference and BMI,and the UA level was significantly correlated with triacylglycerol,postprandial 2 h glucose(2 h PG)(r=0.196,0.174 in boys;r=0.291,0.179 in girls).In boys,the adjusted odds ratio and 95％CI of the highest quartile of UA for triglyceridemia was 2.71(95％CI:0.77-9.58);which in girls,the adjusted odds ratio and 95％CI of the highest quartile of UA for hyperglycemia,hypertension were 8.45(95％CI:1.76-40.52)and 3.93(95％CI:0.66-23.33),respectively,with significant differences.In boys,the area under the ROC curve of UA level,age,waist circumference and BMI which predict the MS were 0.652 0.626,0.621,0.62,respectively,and the differences were significant(all P<0.05).Conclusions The UA level is significantly correlated with the composition of MS,UA detection combining with reference to the age,waist circumference,and BMI is helpful for the identification of high risk groups of metabolic syndrome.