Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

Animals ; Female ; Hippocampus ; physiology ; Learning ; Long-Term Potentiation ; Male ; Memory ; Mice ; Mice, Inbred Strains ; Pregnancy ; Prenatal Exposure Delayed Effects ; psychology ; Tobacco Smoke Pollution

Objective To predict and identify T cell epitopes of major group 3 allergen derived from Dermatophagoides fari-na(Der f 3). Methods The T cell epitopes of Der f 3 were analyzed through the sequence analysis by using the bioinformatics online tools. The five predicted peptides of T-cell epitopes were artificially synthesized. The spleen lymphocytes were co-cultured with the five T cell epitopes by using the modified MTT method and the levels of IL-2,IFN-γ,IL-4 and IL-5 in the supernatant of the cultures were detected by ELISA. Results Five T cell epitopes of Der f 3 were predicted and three of which could pro-mote the proliferation of the mouse spleen lymphocytes. The secretions of IL-2 and IFN-γwere significantly induced and the se-cretions of IL-4 and IL-5 were significantly decreased by three of five prediction epitopes of Der f 3:37GDCPYQISLQSSSHFC-GG54,98IYQHENYDSMTIDNDVALIKLKTPMT123 and 164SELQRVDIDVVSREQCDQLYS184. Conclusion Three T cell epitopes of Der f 3 have been initially identified,which lays the foundation of the diagnosis and treatment of asthma.

General practitioners need not only to have comprehensive knowledge and clinical competency, and also to have the soft skill that are social and personal management skills.In the residency training of general practice, it is necessary to pay attention to the soft skill development.The training institutions should adopt various measures: including soft skills cultivation in training contents, emphasizing soft skills training in the traditional teaching practice, establishing a variety of practice platforms and introducing soft skills in the evaluation and examination system.

Objective:To investigate the complications of traumatic optic neuropathy and to call the surgeons' attention to precaution. Method:Retrospectively analysis of 122 cases patients with traumatic optic neuropathy and 3 cases were analyzed in detail including 1 case with purulent meningitis, another 1 case with internal carotid artery pseudoaneurysm and the other 1 case with internal carotid artery cavernous sinus fistula. Result:Most of the patients had the complications of orbital fracture, maxillofacial fracture, ocular and craniocerebral injury. A few of patients had other injuries all over the body. The case with purulent meningitis was cured with antibiotics. The case with internal carotid artery pseudoaneurysm was cured with neurosurgery. The visual acuity of the both cases were improved. The case with internal carotid artery cavernous sinus fistula died of severe hemorrhea. Conclusion: The patient with traumatic optic neuropathy has the possibility of severe cranial disorders,orbital fracture, maxillofacial fracture and injuries of viscera or limbs. It should be paid mare attention and treated accordingly.

Objective To investigate the prognosis correlation factors of sudden hearing loss.Methods A retrospective analysis was performed in 137 cases (149 ears) of sudden hearing loss.The relationships between the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,tinnitus,diabetes mellitus,high blood pressure and therapeutic effect were observed.Results The total effective rates in ＜ 45 years,45-59 years and ＞ 59 years patients were 86.36％(38/44),77.78％ (56/72) and 57.58％ (19/33) respectively.There were statistical differences in the total effective rate between ＜ 45 years,45-59 years patients and ＞ 59 years patients (x2 =8.128,P =0.004; x2 =4.525,P =0.033).The total effective rates in patients who were treated ≤7 d,8-14 d and ≥ 15 d were 83.52％ (76/91),76.67％(23/30) and 50.00％(14/28) respectively.There were statistical differences in the total effective rate between patients who treated ≤7 d,8-14 d and patients who were treated ≥ 15 d (x2 =13.050,P =0.000; x2 =4.459,P =0.035).The total effective rates in low-mid frequency type,all frequency type,total deafness type and mid-high frequency type were 89.66％ (52/58),84.44％ (38/45),7/12,47.06％ (16/34) respectively.There were statistical differences in the total effective rate between low-mid frequency,all frequency type and total deafness type,mid-high frequency type (P ＜ 0.05).The total effective rates in hearing loss mild degree,middle degree,severe degree,extremely severe degree and total deafness were 87.23％ (41/47),86.11％ (31/36),61.90％ (13/21),7/15 respectively.There were statistical differences in the total effective rate between mild degree,middle degree and severe degree,extremely severe degree and total deafness (P ＜ 0.05).The hearing loss prognosis with the dizziness,diabetes mellitus,high blood pressure was worse.Conclusions It is considered that the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,high blood pressure,diabetes mellitus are related to the total effective rate.The prognosis of hearing loss can be estimated according to these correlation factors.

OBJECTIVE: To summarize the clinical experience with endoscopic transnasal resection of nasal skull- base neoplasms, which involved anterior skull base, pterygopalatine fossa, nfratemporal fossa. METHOD: Clinical data from 73 patients performed on endoscopic transnasal resection of nasal skull-base neoplasms were analyzed retrospectively. RESULT: Total tumor removal was obtained in 54 cases, subtotal removal in 19 cases. In 16 cases of benign tumor, the postoperative survival rate was 100%; Malignancy in 57 cases, of which 16 patients were died, and half-year survival rate was 71.9%. CONCLUSION Endoscopic endonasal approach be able to fully reveal and re- moval of lesions involving the anterior skull base, pterygopalatine fossa and infratemporal fossa. The approach is feasible and safe.
Endoscopy ; Humans ; Nose ; surgery ; Postoperative Period ; Pterygopalatine Fossa ; Retrospective Studies ; Skull Base ; Skull Base Neoplasms ; surgery

Objective To analyze the clinical manifestations and electroencephalogram (EEG)characteristics of agyria-pachygyria for its early diagnosis,treatment and prognosis judgment in clinical practice.Methods The clinical manifestations and EEG features of twenty-four patients with agyria-pachygyria who were diagnosed by CT or magnetic resonance imaging(MRI) at Pediatric Neurology of Children's Hospital of Chongqing Medical University from July 2004 to July 2013 were retrospectively analyzed.Results Of twenty-four patients,eighteen cases were diagnosed as diffuse agyria-pachygyria and six cases were diagnosed as partial agyria-pachygyria.The clinical features were mainly manifested as mental retardation (twenty-four patients),and motor retardation (twenty-four patients),and epilepsy (eighteen patients).All of the twenty-four patients had abnormal EEG pattern which were mainly three tapes.Type Ⅰ had diffused high amplitude alpha and beta activity in all cortical regions,frontal-central,or parietal-occipital region (fourteen patients).Type Ⅱ showed alternating high amplitude bursts with sharp and slow waves (seven patients).Type Ⅲ was characterized by high amplitude spike or sharp wave activity generalized or multifocal distribution and δ,θ wave mixing graphics (twelve patients).Nine of twenty-four patients showed two or three EEG characteristic patterns in an awake-asleep EEG recording.During the follow-up of 1-8 years old,twelve of the thirteen patients who were diagnosed as epilepsy in diffuse agyria-pachygyria had refractory epilepsy,mainly with infantile spasms or Lennox-Gastaut syndrome.One of the five patients who was diagnosed as epilepsy in focal agyria-pachygyria had refractory epilepsy,mainly for partial epilepsy secondary generalized seizures.There was a significant difference between them (P =0.008).Eighteen of twenty patients who had moderate-severe mental retardation or dyskinesia were diagnosed as diffuse a gyria-pachygyria,while two were focal agyria-pachygyria.Both of them had a significant difference (P =0.005).Conclusions Agyria-pachygyria is a brain malformation caused by neuronal migration abnormality.Diffuse agyria-pachygyria is presented with serious clinical manifestations and poor outcome while the clinical manifestation of focal agyria-pachygyria is relatively mild and epilepsy could be controlled by antiepileptic drugs or epilepsy surgery.These characteristics of EEG patterns along with clinical findings could provide important evidence for early diagnosis,timely treatment and prognosis judgment of agyria-pachygyria.

Objective To observe the tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Twenty-three patients were enrolled. According to the different obstructive level, the different operations were chosen to complete upper airway reconstruction in contemporaneous operation group (group A, 13 patients). In the simple palatopharynx level obstructive group (group B, 10 patients), bilateral tonsillectomy and H-UPPP was chosen. Results The operation time in group A was significantly longer than that in group B:(121.0 ± 35.4) min vs.(80.7 ± 25.3) min, P<0.01. The hospital days and adverse events in two groups had no significantly difference (P>0.05). Conclusions Individual therapeutic schedule for OSAHS patients should be formulated. Operating the different obstructive levels simutaneously, which would solve upper airway occlusion and complete the upper airway reconstruction at the same time. No more adverse events happen, compared with the simple palatopharynx level obstructive group, though the operation time may be longer.

The management of national defence science and technology reports was described from their compila-tion, submission, review, communication and use, taking The Scientific Research and Training Center of China Astronauts as an example. The problems in the management of national defence science and technology reports were pointed out, with measures and suggestions put forward for strengthening their management.