Pyriform sinus fistula,owing to rare disease incidence and lacking of awareness,is always a puzzle to neck illness. At the mean time,The frequent delay in accurate diagnosis was reported in the literature. Pyriform sinus fistula should be considered in any children with repeated neck or thyroid infection/mass( mainly on the left side) . The combination of barium esophagography,CT scan and ultrasound is useful to establish the diagnosis. Intraoperative endoscopy-assisted intubation or methylene blue injection through the internal opening as a guide can facilitate identification of the tract during dissection,and it can effectively reduce the relapse rate.

Objective To assess the clinical value of taken out embryo by hysteroscopy in treatment of caesarean scar pregnancy. Methods 20 cases of caesarean scar pregnancy from May 2014 to April 2015 were treated with hysteroscopy. Results All the 20 cases were treated by hysteroscopy successfully, none of them suffered from conver-sion to laparotomy, perforation of uterus and heavy vaginal bleeding. Conclusions The operation of taken out embryo by hysteroscopy is effective operation in treating caesarean scar pregnancy with mini-trauma, few distress, and less cost.

Aim To investigate the immunoregulative action of polysacchrides of Spirulina platensis ( PSP ) on peripheral blood mononuclear cells ( PBMCs) in pa-tients with chronic hepatitis B virus infection. Meth-ods Proliferation and cycle of PBMCs from patients with chronic hepatitis B virus infection were measured by MTT colorimetry and flow cytometry respectively. The concentration of IFN-γ, IL-2 , IL-4 in supernatants of PBMCs were examined by ELISA. The mRNA ex-pression of IFN-γin PBMCs from patients with chronic hepatitis B virus infection was detected by RT-PCR. Results PSP could induce proliferation of PBMCs in patients with chronic hepatitis B virus infection. In ad-dition, PSP could increase the protein expression of IFN-γ and IL-2 in supernatants of PBMCs in patients with chronic hepatitis B virus infection, and PSP could also enhance the mRNA expression of IFN-γof PBMCs in patients with chronic hepatitis B virus infection. However, PSP inhibited the protein expression of IL-4 of PBMCs in patients with chronic hepatitis B virus in-fection. Conclusion PSP can promote the immune function and plays an important immunoregulation function on patients with chronic hepatitis B virus in-fection.

OBJECTIVE:To observe the effects of RAD51 gene polymorphism on cancer prognosis and its relationship with therapeutic efficacy of cisplatin chemotherapy in patients with cervical cancer. METHODS:193 cervical cancer patients were selected and genotyped by TaqmanTM genotyping method. Therapeutic efficacy and survival period were observed in cisplatin chemotherapy combined with radiotherapy. RESULTS:The mean survival rate and therapeutic efficacy was significantly correlated with RAD51 genotype. The patients carrying the T gene had better response to drugs,compared to patients with type GG (P<0.05),and the average survival rate significantly increased(P<0.05). CONCLUSIONS:Genetic variation in RAD51 have obvious influence on the prognosis of cervical cancer chemotherapy. Therefore,RAD51 G172T genotypes give effective prognosis information about cervical cancer patients who received cisplatin chemotherapy.

OBJECTIVE:To provide reference for reasonable iron supplement during pregnancy. METHODS:5023 iron sup-plement prescriptions for 800 delivery women receiving antenatal care and childbearing in our hospital in 2014 were analyzed retro-spectively. According to international authoritative guideline for gestational iron supplement,the rationality of iron supplement for pregnant women in our hospital was investigated in terms of timing,duration and dosage. RESULTS:The iron supplement timing and duration of 800 pregnant women all met the criteria;among 5023 iron supplement prescriptions,62 prescriptions of preventive iron supplement and 3875 prescriptions of iron supplement for iron deficiency were up to the standard. CONCLUSIONS:The dos-age of gestational iron supplement are unreasonable in our hospital at a certain extent. It is necessary to strengthen clinical medica-tion management to guarantee safe and rational iron supplement in pregnant women.

Objective To analysis the consequence of current perception threshold (CPT) by different frequency and time of transcutaneous electrical nerve stimulation (TENS). Methods CPT of foramen area and arm area was measured to evaluate the effect of TENS. Different frequency and time of TENS was given to 30 healthy volunteers. Stimulating to Hegu, CPT of the foramen area and the arm area on the same side was measured. Results CPT of the foramen area increased with stimulation. Low frequency of TENS inhibited the chronic pain significantly(P＜0.05),high frequency of TENS inhibited both of the chronic pain and the acute pain(P＜0.05). The inhibition of pain is more influenced by the frequency of TENS than the time of it. Conclusion Channel and point of TENS can influence CPT of the specific reaction area. And the choice of appropriate frequency of the treatment is more important than extending the treatment time alone.

Tyrosine kinase inhibitors (TKIs) are used as the primary first-line treatment for advanced hepatocellular carcinoma, and the combination of immune checkpoint inhibitors (ICIs) and angiogenesis inhibitors have also been recommended as first-line treatment recently. For hepatocellular carcinoma patients with portal vein tumor thrombus, hepatic artery infusion chemotherapy (HAIC) is supported by progressively more evidence in improvement in the overall survival benefit. Based on relevant literatures and combined with clinical practices, the authors investigate the clinical application and development trends of TKIs, ICIs and HAIC in the first-line treatment for advanced hepatocellular carcinoma.

Next-generation sequencing has boosted the development and application of non-invasive prenatal testing.Non-invasive prenatal screening of fetal aneuploidies (T21/T18/T13) has been widely applied around the world as the well-recognized best screening method because of its high sensitivity, low false-positive rate and false-negative rate.Non-invasive prenatal testing of fetal sex chromosome aneuploidies, common chromosome deletion-duplication syndromes and several monogenic disorders has also become technically feasible.It can be expected that primary challenges in the future would be the issues of clinical services and proper managements.

Objective To observe the correlation of estrogen,fasting insulin(FINS),fasting plasma glucose (FPG),glycosylated hemoglobin(HbA1c),blood lipids and carotid arteries -membrane thickening(IMT)in the postmenopausal women with type 2 diabetes.Methods 63 postmenopausal women with type 2 diabetes were divided into normal IMT group(group A),IMT thickening group(group B),plaque group(group C)according to the vascular ultrasound carotid artery intima thickness,at the same time 15 cases of healthy physical examination as control group (group D).All of the groups were detected the plasma total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),fasting plasma glucose(FPG),gly-cosylated hemoglobin(HbA1c),follicle-stimulating hormone(FSH),estradiol(E2).Results Compared with group A,the levels of FINS,IR,HbA1c,TC,LDL-C in group C was higher(t=16.83,14.44,2.50,2.38,2.42,all P<0.01 or P<0.05),however,the results of E2,HDL-C was decreased(t=7.32,5.51,all P<0.01).The levels of FINS,HbA1c,TC,LDL-C,FSH,IR in group D was lower than those of group C(t=19.74,36.44,8.64,7.95, 27.13,6.71,all P<0.01),On the contrast,the levels of HDL-C,E2 were elevated(t=11.34,8.72,all P<0.01). The Pearson's correlation analysis showed that E2 had negative correlation with FINS,IR,TC,LDL-C (P<0.01 or P<0.05).E2 had positive correlation with HDL-C(P<0.05).Logistic regression analysis showed that IMT and FINS,IR,HbA1c,LDL-C were positively correlated(OR=2.94,72.63,27.30,98.18,all P<0.01),while nega-tively correlated with E2 levels(OR=2.94,P<0.01).Conclusion The increased level of estrogen was a protective factor of carotid artery atherosclerosis in postmenopausal women with type 2 diabetes.

Objective To study three-dimensional computerized quantification for clinical stage Ⅰ lung invasive adenocarcinoma with different histopathological subtypes.Methods Pathological and HRCT data of 273 patients within clinical stage Ⅰ lung invasive adenocarcinoma underwent surgery from January 2005 to December 2012 were retrospectively collected.The proportion of ground glass opacity component and solid component in tumor were calculated by three-dimensional computerized quantification.All specimens were classified into 3 grades (grade 1 as the lepidic pattern of invasive adenocarcinoma,grade 2 acinar or papillary patterns,grade 3 micropapillary or solid patterns).The proportion of different components among different histopathological grades was evaluated by Kruskal-Wallis test.The correlation between components in tumor and histopathologic subtypes grade were evaluated by Spearman correlation.Results In 273 patients,49(17.9％) were assessed as grade 1,208(76.2％) grade 2,and 16(5.9％) grade 3.The proportion of ground glass opacity component and solid component in grade 1,grade 2,and grade 3 were 18.40％ (10.00％-33.45％),6.55％ (2.00％-18.00％),1.70％ (0.20％-3.85％) and 29.80％ (11.75％-47.35％),66.60％ (35.40％-83.85％),88.50％ (75.28％-93.60％),respectively.Significant differences among different histopathological grades were observed(x2=37.74,47.73,P＜0.01).The proportion of ground glass opacity component was negative correlation with histopathologic grade(r=-0.37,P＜0.01),while the proportion of solid component was positive correlation with histopathologie grade(r=0.42,P＜0.01).Conclusion Three-dimensional computerized quantification for lung invasive adenocarcinoma may predict histopathological grade.