OBJECTIVE: To investigate the clinical characteristics, treatment and the effectiveness of sinonasal inverting papilloma with recurrence and malignant transformation. METHOD: Retrospective comparative analysis of sinonasal inverting papilloma with recurrence and malignant transformation treated from Jan. 2008 to Oct. 2012 in our hospital. RESULT: All the 24 patients with recurrence had the history of sinonasal surgery. Among them, 17 patients recurred once,6 recurred twice and 1 recurred three times. The recurrence time was from 1 month to 14 years after operation. Four patients relapsed within half year after 5 months to 4 years follow-up and the recurrence ratio was 16.7% (4/24). All the 4 patients with recurrence had an operation once again and one of them was given chemoradiotherapy after surgery whose pathological results showed canceration. There was no recurrence among the all of 24 patients followed up until now. Among 5 patients with malignant transformation, 3 patients of them were given radiochemotherapy after surgery. Except 1 patient died of extensive recurrence, 1 received other operation after relapsed twice and 1 lost follow up,all the others were alive without recurrence during 10 months to 4 years. CONCLUSION The surgical treatment with completely and positively is the firse choice and an effective management for sinonasal inverting papilloma. To the patients with recurrence on many times and malignant tumors, post-operative radiation or chemotherapy should be considered when needed.
Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; pathology ; Paranasal Sinus Neoplasms ; pathology ; Retrospective Studies

Disease Progression ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; pathology ; Leukomalacia, Periventricular ; pathology

Objective: To evaluate the role of HPV16E6,cyclin D1 ,and human telomerase transcriptase (hTERT) in the development and progression of nasopharyngeal carcinoma ( NPC ) and to discuss the clinical significance. Methods: Immunohistochemistry was used to detect the expression of HPV16E6, cyclin D1, and hTERT in paraffin-embedded nasopharyngeal carcinoma tissues and nasopharyngeal chronic inflammation tissues. The relationship between their expression with the clinicopathological features of NPC was analyzed; the influence of their expression on prognoses of patients was also analyzed. Results: The positive rates of HPV16E6,cyclin D1 ,and hTERT in NPC tissues were 62. 5%(35/56) ,50. 0%(28/56) , and 67. 9%(38/56) ,respectively, which were significantly higher than those in the inflammation tissues (P<0. 05). The positive rates of HPV16E6,cyclin D1 ,and hTERT increased with the decrease of differentiation grades, increase of clinical stage and presence of lymph node metastases ( P < 0. 05), but had no relationship with patients' age or sex(P>0. 05). HPV16E6 expression was positively correlated with cyclin D1(r=0. 480,P<0. 001) and hTERT (r=0. 494,P<0. 001)in NPC tissues. The mean survival period and median survival period in HPV16E6,cyclin D1 and hTERT positive patients were lower than those in the negative ones (P<0. 05). Conclusion: High expression of HPV16E6,cyclin D1 ,and hTERT might be involved in the development and progression of NPC. HPV16E6 may interact with cyclin D1 and hTERT, contributing to the development of NPC. Examination of the three agents may help to predict the prognoses of NPC.

Objective: To evaluate the role of enteral nutrition with dietary fiber and medium chain triglycerides in postoperative patients with gastric cancer. Methods: Forty patientswith gastric cancer receivedenteral diet with dietary fiber and medium chain triglycerides for 7 days. Enteral feeding was initiated 48hours after surgery. Host biochemistryindicators, nutritional parameters and immunity were monitored. Results: With surgical trauma, patients'nutritional status and immunity were impaired, and after nutritional support, the nutritional and immune parameters increased significantly. Conclusions: In postoperative patientswith gastric cancer, enteral nutrition with dietary fiber and medium chain triglycerides can improve the nutritional status and immunity.

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic
left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.

Objective To assess the value of intraoperative ultrasonography during the uterus septum resection under a hysteroscope.MethodsThe uterus septum resection was performed under the guidance of transabdominal ultrasonography by using a hysteroscope in 30 patients.The operative procedure and the position of the hysteroscope were monitored,and the depth of the dissection and thickness of the myometrium in the fundus uteri were measured with transabdominal ultrasound during the operation.ResultsThe thickness between the incisal surface and serosal layer in the fundus uteri was within the normal limits in 28 cases.In 2 cases,the tissue was over-ectomized.The position of the urethral catheter balloon was correct in all of the 30 cases.Three months after the procedure,reexamination by transvaginal ultrasonography showed that the uterine cavity was normal in the patients.ConclusionsIntraoperative ultrasonography is quick,safe and precise for monitoring uterus septum resection.It is valuable for establishing surgical strategy and reducing operative complications.

Objective To study the effects of ketamine on glutamate-induced apoptosis in neuronal cells using PC 12 pheochromocytoma cell line (provided by Chinese Academy of Phamacological Research) .Methods After being incubated in the culture medium containing 7S-NGF for 6 days. Over 95 % of the PC cells differentiated into neuron-type cells. The 7S-NGF induced differentiated neuronal PC 12 cells were seeded in 24-well plates pre-coated with poly-L-lysine(2?106 cells per well) .24 hours later the PC12 cells were exposed to glutamate 20 mrnol/ L(group A); glutamate 20 mmol/L + ketamine 0.1 mmo/L (group B); glutamate 20 mmol/L + ketamine 1.0 mmol/L (group C); glutamate 20 mmol/L + D-APS 100 )Ltmol/L(group D) and new culture medium containing no 7S-NGF(group E, control group), and incubated for 18 hours .The viability of the cells was evaluated by the ability of the cells to reduce the tetragotium derivative MTT into a blue formagan salt. DNA fragmentation indicative of apoptosis was detected using TUNEL technique. Results in group A following incubation with glutamate 20 mmol/L for 18 h , at 37℃, the viability was PC 12 cells was reduced to 37%? 6% However ketamine , when added to the culture medium to gather with glutamate , inhibited glutamate-induced cell death . The viability of PC 12 cell was 65 ? 7% in group B an 99?10% in group C. Ketamine appeared to attenuate the apoptotic process, because the number of the apoptotic cell bodies, determinated by YUNEL was also reduced by ketamine, with only 15-20% of neuronal cells staining positive after exposure to 20 mmol/L glutamate.The difference between group A and C was very significant (P

Objective To explore the effect of deep vein thrombosis(DVT)assessment scale on prevention of deep vein thrombosis in malignant tumor patients?Methods Eight hundred malignant tumor patients were divided into intervention group and control group according to admission time,400 cases in each group?The control group received traditional nursing.Methods of treatment and nursing,while the intervention group received pertinent nursing care based on the risk factors for DVT induced for the investigation among the patients using deep vein thrombus assessment scale.Result The incidence of DVT in the intervention group was significantly lower than that of the control group(P<0?05).Conclusions The deep vein thrombosis assessment scale may effectively predict the population at high risk of deep vein thrombosis?The implementation of effective nursing intervention may reduce the incidence of DVT?

Objective To study the correlation between serum homocysteine (Hcy) levels and chronic heart failure (CHF) with ultrasound cardiac function patients.Methods The subjects were 88 cases of CHF (CHF group) in our hospital between April 2014 to June 2015 between patients,selected 65 cases of healthy people as a control group over the same period in our hospital,using color Doppler ultrasound measurement of two groups patients of the left ventricular ejection fraction of patients groups (LVEF) and left ventricular end-diastolic diameter (LVEDd),and compared serum Hcy and NT-proBNP levels,LVEF and LVEDd in different NYHA classification patients,analysis of serum Hcy and NT-proBNP levels and LVEF,LVEDd between correlation of serum Hcy levels on cardiovascular incident.Results CHF group of the Hcy,NT-proBNP levels and LVEDd were significantly higher than control group (P ＜ 0.01),LVEF was significantly lower than the control group (t =31.78,P =0.00);different NYHA functional class (Ⅱ ～ Ⅳ level) of Hcy,NT-proBNP,LVEDd and LVEF compared were statistically difference (P ＜ 0.01);Pearson correlation analysis showed,CHF patients with LVEF serum Hcy levels were negatively correlated (r2 =0.974,P ＜ 0.01),with LVEDd was positively correlated (r2 =0.896,P ＜ 0.05),and higher serum Hcy levels,the higher the rate of cardiovascular happened in patients with CHF.Conclusion The serum Hcy and NT-proBNP levels in patients with CHF were significantly higher than healthy,and with the deterioration of heart function and increased while the LVEF was negatively correlated positively with LVEDd,cardiovascular events in high Hcy levels may also increase the incidence risk,so Hcy levels is expected as a new diagnostic marker CHF conditions change.

10 h. Results 15 patients had been misdiagnosed as epididymis orchitis or acute abdomen and undergone orchiectomy because of necrosis of the testicles,including 11 cases of intrascrotal torsion (testicular torsion in scrotum with an orchiectomy rate of 79%) and 4 cases of cryptorchidism with torsion.3 cases scrotal orchidopexy has been performed and during the follow up ( 6～36 months) the testicle in 2 of which appeared viable and normal while testicular atrophy has been observed in 1.In recent years 11 adolescents underwent exploration because of acute scrotal pain,7 cases being testicular torsion and 4 acute epididymitis. Conclusions It is emphasized that in younger patients suffering suddenly from pain in scrotum, especially occurring at night,the diagnosis of testicular torsion should be considered.Differentiating cryptorchidism with torsion from incarcerated hernia or acute abdomen,testicular torsion in scrotum from acute testitis and epididymitis should be serious considered.In order to save the testicle with early surgical exploration orchidopexy might be mandatory to aviod recurrence.