Locally advanced nasopharyngeal carcinoma ( NPC) invaded with paranasal sinus as death is associated with disease and independent prognostic factors for local recurrence .Its symptoms are various and atyp-ical,and often causes misdiagnosis or missed diagnosis .Local recurrence and distant metastasis are the main cause of treatment fails .Currently , there are few literature about NPC intruding paranasal sinus .Its occurrence rate,clinical manifestation,imageological change,intruding pathways,diagnosis,treatment and prognosis are sum-marized in this paper .

OBJECTIVE To understand the susceptibility to antituberculous agents for patients with primary and acquired drug resistance of Mycobacterium tuberculosis. METHODS M. tuberculosis positive sputum samples were collected from Jun to Dec 2006. Ameliorative Lowenstein-Jensen culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis by typing using PNB and TCH. Totally 217 samples were confirmedtobe positive by culturing. Drug susceptibility test against streptomycin (SM),isoniazid (INH),rifampicin (RFP) and ethambutol (EMB) was conducted. RESULTS The total drug resistance rate was 65.90%,the initial drug resistance rate was 39.81% and the initial multi-drug resistance rate was 16.67% ;the acquired drug resistance rate was 91.74%,and the acquired multi-drug resistance rate was 74.31%. The main causes of drug resistance were irregularit of treatment at beginning and preterm stop of the freatment course by patients own selves,which accounted for 71.6%. CONCLUSIONS The drug resistance of M. tuberculosis is caused by irregular treatment,so the key to prevent and control drug resistance is rational and whole-course treatment.

OBJECTIVE:To provide suggestions and countermeasures for improving the accessibility of national essential medi-cines. METHODS:Based on the theoretical analysis,the questionnaire was designed for the pre-survey and formal survey on the experts from universities,enterprises,government agencies and non-governmental organizations,and analytic hierarchy process was used to analyze and discuss the valid questionnaire. RESULTS:Totally 35 question naires were sent out and 27 were effective-ly received with effective rate of 77.14%. The physicians and pharmacists’cognition of essential medicine system and essential medicine,and the reasonable degree of public bid prices of essential medicine,the fairness and impartiality of essential medicine bidding process were the key influential factors;the prescription,provision,reimbursement of essential medicine,and the financial compensation to primary public health care institutions that sell essential medicine by zero-slip were the secondary factors;primary health care institutions’monitoring on the use of essential medicine(such as prescription rate,etc.),the participation of social se-curity sector in bidding and purchasing of essential medicine,the reasonable degree of pricing of essential medicine,the monitoring of the price of essential medicine,and the compensation to manufacturers of essential medicine were the general factors. CONCLU-SIONS:The accessibility of essential medicine involves many stakeholders,whom impact from different levels. Therefore,all rele-vant stakeholders should be coordinated to gradually improve the accessibility of essential medicines.

Traumatic asphyxia is a result of sudden or severe compression of the thorax and/or the upper abdomen.A sudden increase of intravascular pressure transmitted to the intra-and extracerebral vessels may cause petechial hemorrhage in the brain and in the skin over the head,face,neck and shoulder regions.Severe cerebral anoxia accompanying the injury may lead to cerebral edema and the appearance of signs of increased intracranial pressure as well as ARDS following hypoxemia.Spinal puncture and EEG are helpful in early diagnosis.The essential therapeutic measures consist of improvement in ventilation,dehydration and the use of glucocorticoid hormones.By such manoeuvres,11 of 12 patients we treated recovered satisfactorily and only 1 of them succumbed.

Objective To investigate the risk factors of incidence of hypertensive disorder complicating pregnancy(HDCP)and provide reference for prevention and treatment of HDCP.Methods The clinical information of 2 217 cases of maternal delivery were retrospectively analyzed;The relevant social factors and obstetric factors of HDCP were analyzed.Results 186 cases of HDCP occurred in 2 217 cases of maternal,the incidence rate of HDCP was 8.4%.The single-factor analysis showed that the place of residence.prenatal system checks and parity had certain degree of contact with incidence of HDCP(χ2=11.2331,10.6781,5.4456,all P＜0.05),and the age,abortion history and parity had no significant correlation with incidence of HDCP(χ2=4.9201,3.0134,1.7301,all P＞0.05).Multivariate Logistic regression analysis showed that the rural living and no prenatal system check were risk factors of incidence of HDCP.Conclusion The maternal of rural living and no prenatal system check were the high-risk population of HDCP,and emphasis assessment and reasonable control these factors could reduce the incidence of HDCP.

Objective To investigate the influence of human menopausal gonadotropin(HMG)administration at different phase of follicular development upon the outcome of in vitro fertilization-embryo transfer(IVF-ET)in the long-program.Methods A retrospective analysis was performed in 145 patients underwent the long program IVF-ET,who were normal in ovarian reservation but with low levels of serum leteinizing hormone(LH)(＜ 1 U/L)after the pituitary down-regulation.According to the time point of HMG administration,the patients were classified into three groups:early follicular phase(group 1,43 patients),midfollicular phase(group 2,46 patients)and late follicular phase(group 3,56 patients).The outcomes of these three groups were compared.Results Between the three groups,there was no difference in the down-regulation time,days receiving gonadotropin(Gn),the number of oocytes retrieved,day of estradiol(E2)on the day receiving chorionic gonadotrophin(hCG)injection,start date and interim LH,fertilization rate and cleavage rate (all P ＞ 0.05).In group 3,the total Gn dosage([2225 ± 292]U)was lower than that of group 1([2624 ± 422]U)(P ＜ 0.05)and group 2([2472 ± 417]U)(P ＜ 0.05).In group 1,the LH level on the day receiving hCG[(0.46 ± 0.37)U/L]was lower than that in group 2[(0.72 ± 0.58)U/L](P＜0.05).The rate of usable embryos in group 3[62.5％(288/461)]was higher than that of group 1[55.0％(170/309)]and group 252.8％(208/394)](P =0.011).Though the high qualified embryo rate,clinical pregnancy rate and implantation rate in group 3 were higher than that in goup 1 and group 2,and the abortion rate in group 1 was higher than that of group 2 and group 3,the difference was not significant(P ＞ 0.05).Conclusion For the patients with over-suppressed LH in the long-program pituitary down-regulation but with normal ovarian reservation,additional HMG during late follicular phase is helpful to improve the high qualified emryo rate,excellent rates of embryos,embryos availability,implantation rate and clinical pregnancy rate,and lower the abortion rate.

Objective:To study the epidemiology of inpatients with fractures and discuss its effect on health education.Methods:Therer were 6290 inpatie nts with fracture investigated retrospectively.FoxPro and SPSS were used for statistical analysis.Results:The mean age of the patients was 41.03±20.05 years.The fraction male to female patients was 2.39:1.The mean hospitalized days were 24.11±22.73 days (±s).A majority(63.5%) of the patients were admitted to the hospital by emerg ency.Fractures in 15 parts accounted for 70% of total fractures in 6 hospital, 7 of which accounted for more than 50% of total fractures in each hospital.Discussion:Health education should be carried out according to risk factors as well as age and gender.The devel opment of the model,which combines prevention,first-aid and rehabilitation,is t he trend of health education for fractures.The basic knowledge of fractures in these 15 parts should be learned by orthopedic nurses.Patient education should be carried out individually.The hospital's situation should also be considered.

Objective Evaluate the immunotoxicity of Ginenoside Compound K Injection.Methods Active Systemic Anaphylaxis (ASA)tests and Passive Cutaneous Anaphylaxis (PCA)tests were used to evaluate Ginenoside Compound K Injection.Results In the ASA tests,positive control group showed pole-strength anapbylaxis,both the high-dose group and the low-dose group of Ginenoside Compound K Injection didn't produce allergic reaction and the body weights of all groups showed no significant differences.In the PCA tests,all rats of positive control group caused blue spots with their diameters bigger than 5 mm (diameters on the left side of blue spots was (10.1± 3.34) mm and diameters on the right side of blue spots was(7.57± 1.94)mm.Serum IgE was significantly increased.While both high dose and low dose of Ginenoside Compound K Injection group didn't show blue spots with their diameters greater than 5 mm and their IgE levels showed no significant differences compared with negative control group.Conclusion Ginenoside Compound K Injection showed no immunotoxicity under these experimental conditions.

Objective To observe the influence of systemic and intraperitoneal hyperthermic perfusion chemotherapy on serum vascular endothelial growth factor(VEGF) and human epididymis protein 4 (HE4) in patients with ovarian cancer.Methods 116 cases with ovarian cancer were,randomly divided into the observation group and the control group according to the number table,58 cases in each group.The observation group was given systemic and intraperitoneal hyperthermic perfusion chemotherapy,and the control group received systemic chemotherapy,they all completed a total of two cycles of chemotherapy.Serum VEGF and HE4 were measured before and after chemotherapy.Results The total effective rate of the observation group was 74.1％,and that was 56.9％ of the control group,the difference was significant (x2 =4.290,P ＜ 0.05).After chemotherapy,the serum VEGF and HE4 were signifi cantly decreased in two groups,and compared with the control group,the observation group decreased more significantly(t =3.180,2.725,all P ＜ 0.05).Conclusion Systemic and intraperitoneal hyperthermic perfusion chemotherapy in treatment of patients with ovarian cancer can significantly reduce serum VEGF and HE4.

Objective To map the mutation gene of autosomal dominant congenital lamellar cataract in a family pedigree of four generations.Methods A Family with non-syndromic congenital cataract was recruited from the Eye Center of Tongren Hospital affiliated to Capital Medical University.Family history was recorded.Twenty-eight members of the family pedigree(including twelve affected and sixteen unaffected individuals)were enrolled into the study with informed consent.The twelve affected individuals underwent full clinical and ophthalmological examinations to rule out any concomitant disorders.The sixteen unaffected individuals only underwent ophthalmological examination.Blood samples were collected from all the 28 subjects for genomic DNA preparation.Eighteen different genes were previously reported to be associated with non-syndromic autosomal dominant congenital cataract(ADCC).Multiplex polymerase chain reaction(PCR)was carried out with microsatellite markers near to candidate loci related to congenital cataracts.PCR products from each DNA sample were separated on a 6% polyarcylamide gel and analyzed.Exclusion analysis was performed by allele sharing analysis and gene sequencing.Results The clinical phenotype in the family was isolated corroborating autosomal dominant congenital lamellar cataract.No mutation was found in the eighteen genes in all twenty-eight subjects.Eighteen candidate genes were excluded by allele sharing method and gene sequencing.Conclusion All known ADCC loci have been excluded from this family,which further indicates the clinical and genetical heterogeneity of congenital cataract,and an important clue is provided for finding more cataract responsible genes.Further study should be carried out to screen other relevant genes or loci in patients with ADCC.