OBJECTIVE To investigate the expression of SleX and CD24 in nasal inverted papilloma and its pathologic features.METHODS HE staining were conducted to study the pathologic features in specimens of 11 cases with nasal inverted papilloma. Further,immunohistochemistry stain for SleX and CD24 were performed in total specimens.RESULTS One case(9.1%) was diagnosed as severe atypical hyperplasia but tumor cells did not invaded basal membranes.SleX staining located at cell membranes. Positive SleX staining was found in 9 specimens (81.8%) and 1 normal nasal epithelium (16.7%).CD24 staining located in cytoplasm.Positive CD24 staining was found in 8 specimens of nasal inverted papilloma (72.7%). CD24 was negative in nasal epithelial cells and only a few lymphocytes were positive.CONCLUSION Some cases of nasal inverted papilloma are diagnosed with severe atypical hyperplasia.Most of cases express CD24,so nasal inverted papilloma may be a borderline tumor.Expression of SleX and infiltration of inflammatory cells suggest that nasal inverted papilloma may be related to inflammatory reactions.

Objective To investigate the awareness and utilization of community family doctor services of residents in Beijing and analyze its influential factors.Methods Multistage random sampling was adopted to enroll residents in Beijing from eight community health centers in Haidian District, Xicheng District and Daxing District,to investigate the awareness and utilization of community family doctor services.Customized questionnaires were recovered for descriptive statistics and influential factor analysis.Results All the 3 008 effective questionnaires were recovered.The results found that 92.2% of the residents used community family doctor services.Higher utilization rates of community family doctor services was found among those residents of chronic diseases,those with their family′s annual average outpatient expenses in the medium level,those with their first choice of medical visits in the community health centers,and those who are aware of family doctor service.Services of the most frequent use in the recent year were physical examination and follow-up phone call(87.3% and 73.4% respectively);those of lower frequency were door-to-door service,health assessment,preventive health care,physical examination,health education and consulting,and rehabilitation service.Factors of statistical significance on utilization of community health services were health condition,financial condition and awareness of community family doctor service(P<0.05).Conclusions Residents in Beijing have a high awareness and utilization of community family doctor services,yet some items of services are seldom used.Health condition,financial condition and awareness of community family doctor service are major influential factors for utilization of community health services.

Avian influenza virus H6N1 subtype has been circulating in aquatic bird and terrestrial bird,and is the most frequently detected subtype of influenza A virus in those hosts.Genetic analysis results suggested that this virus might be the progenitor of the highly pathogenic avian influenza H5N1 virus,as seven of eight gene segments of those viruses had a common source.As continuing evolution of H6N1,it could spread across species barriers to mammals and had strong infection ability in mice,swine and ferrets.Serological epidemiological survey showed that a few people were positive for H6 avian influenza virus antibody and then the world's first human infection with influenza virus H6N1 subtype was reported in May 2013.Therefore,with the expansion of the host range of the virus,gene mutation and gene reassortment of H6N1 virus can occur in these hosts,and then it may evolve into novel variant strain with infected human potential.

Objective To observe the clinical effect of the combined medication to prevent postoperative adjuvant chemotherapy-related nausea and vomiting after lung cancer surgery.Methods One hundred and fifteen patients under cisplatin-based chemotherapy were randomly divided into the control group ( n =58 ) and the treatment group( n =57 ).For the control group,Azasetron ( day 1-5 ) and dexamethasonewere (day 1-3 )were injected intravenously with a dose of 10 mg/day at half an hour before chemotherapy.For the treatment group,intramuscularinjectionof promethazine (25mg/day,30minsbeforesurgery ) and metoclopramide( 10 mg/day,30 mins before surgery )and intravenous infusion of omeprazole (40 mg/day,45 mins before surgery)were given from day 1 to day 5 in addition to the treatment for the control group to relieve chemotherapy-induced acute and late-phased nausea and vomiting.ResultsThere were no significant differences between the two groups in controlling acute nausea and vomiting in terms of complete response rate (Ps ＞0.05 ).However,there were significant effect on late-phased nausea,with an effective rate of 87.7％(50/57) in the treatment group versus 72.4％ (42/58) in the control group at day 2 after treatment( x2 =4.21,P ＜ 0.05 ),and 84.2％ (48/57) vs.67.2％ ( 39/58 ) at day 3 ( x2 =4.49,P ＜ 0.05 ),91.2％ ( 52/57 ) vs.77.6％ (45/58) at day 4 ( x2 =4.05,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.81.0％ ( 47/58 ) at day 5 ( x2 =5.04,P ＜ 0.05 ).Furthermore,there were significant effect on late-phased vomiting,with an effective rate of 91.2％ (52/57)in the treatment group versus 74.1％ (43/58) in the control group at day 2 after treatment ( x2 =5.84,P ＜ 0.05 ),and 91.2％ ( 52/57 ) vs.70.7％ ( 41/58 ) at day 3 ( x2 =7.84,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.79.3％ ( 46/58 ) at day 4 ( x2 =6.03,P ＜ 0.05 ),98.2％ (56/57) vs.87.9％ (50/58) at day 5 ( x2 =5.77,P ＜ 0.05 ).The common side effect in both group were dizzy,headache and coporostasis,with no significant difference [ 15.8％ ( 9/57 )vs.20.7％(12/58),x2 =0.46,P=0.49 ].ConclusionThe combinational medication used in the treatment group prominently reduced the incidence of chemotherapy-induced nausea and vomiting after pneumonectomy,especially the late-phased nausea and vomiting.

OBJECTIVE:To explore the comprehensive model for the prevention and treatment of community hypertension.METHODS:By questionnaire survey,the community hypertension target population was screened and the drug use in hypertensive patients was analyzed statistically.RESULTS:Of the 65 000 community residents investigated,1 250 were found to be hypertensive patients,with a total treatment rate of 80.0%;only 32.8% were treated with at least 2 kinds of drugs,and the overall blood pressure control efficacy was poor.CONCLUSION:The program of prevention and treatment for community hypertensive patients is conducive to patients' long term adherence to medication,scientific and rational drug use and effective and stable control of blood pressure.

Objective To observe the effects of the Ossatron high-energy shock waves on bone nonunion and delayed union.Methods Between October 2004 and October 2005,18 patients with nonunion and four patients with delayed union were treated with high-energy extracorporeal shock wave therapy(Ossatron,HMT Co., Swiss).Facture lines were located with C-arm X-ray before treatment.Parameters of shock waves were decided according to fracture sites.Patients with unstable fixation received plaster or bracing for 6 to 8 weeks after treatment. After therapy,follow-up radiography was performed at 6 and 12 weeks and monthly afterwards until the fracture united. Results The mean follow-up was 6.7 months(range,3 to 12 months).There were no complications except local petechial hemorrhage and local swelling in 10 patients.Thirteen patients(59.1%)got bony union,including 12 patients(66.7% )with stable internal fixation,and the average healing time was 4.3 months(range,6 weeks to 6 months).Nine fractures(40.9%)still suffered nonunion.Conclusion High-energy shock waves are a good alternative therapy for nonunion and delayed union,with obvious advantages of being non-invasive and safe.

Objective To observe the efficiency of clopidogrel combined with emergency corona interventional therapy for non-ST segment elevation myocardial infarction.Methods A total of 112 patients with non-ST segment elevation myocardial infarction who were admitted in our hospital from February 2004 to November 2007 were divided into 2 groups at random with 56 patients in each,the experimental group and the control group.All patients were treated with emergency corona interventional therapy and the other routine standard therapies.The experimental group was treated with clopidogrel(75 mg,once per day for 8 weeks),and the control group administered ticlopidine(250 mg,twice per day for 8 weeks).The two group were followed up for a time of half a year.Results The TIMI(thrombolysis in myocardial infarction) myocardial-perfusion grade 3 angiographic flow was achieved in 91.1% of the experimental group,higher than that of the control group(87.5%),but there was no significant difference between them.What's more,there was no obvious difference between the 2 group in cardiac functional grading and life-threatening bleeding.The experimental group had significantly lesser hyporrhea,and lower platelet degradation and total white blood cells counts in comparison to the control group.After the followed-up of half a year,there was significant difference between them in combination-end point.Conclusion Addition of clopidogrel is effective in emergency corona interventional therapy for non-ST segment elevation myocardial infarction,which can degrade the risk of emergency corona interventional therapy.

Objective To learn the awareness,attitude and behavior changes of medical workers to the family doctor service and the influential factors on their utilization of such service since the service is in place.The purpose is to provide theoretical basis to establish the family doctor service model and the incentive mechanism in line with the development of community health service in Beijing.Methods Eight community health centers were sampled randomly from three representative areas of Haidian,Xicheng and Daxing districts,which were grouped randomly as one intervention group and one control group.All the medical workers surveyed were subj ect to the research.The control group was managed as to the existing management mode,and the intervention group was classified and managed according to the new family doctor service model.A questionnaire survey was made to collect data from the baseline and final stages.Comparisons were made among the districts,institutions,and before-after intervention of the institutions themselves to evaluate the effects of the service model and incentive mechanism.Results The survey found a higher awareness by medical workers to such service,higher recognition and satisfaction, and lower rate of services provided by medical workers.The logistic regression analysis found the influential factors for willingness of medical workers to work as family doctors,include group difference, workload changes after signoff as family doctors,residents′acceptance of the community first visit system,recognition or not for whether a family should have a community service team,residents′acceptance,and the general comments on family doctor service (P< 0.05 ).Conclusions Higher incentives of community doctors to embrace family doctor service,calls for the medical workers to change their perception,better incentive mechanism and greater promotion efforts for family doctors′services.

Objective The purpose of this study is to explore the clinical value of CT angiography( CTA) in the diagnosis of multiple intracranial aneurysms.Methods The data of CTA and DSA from 74 patients with multiple intracra-nial aneurysms from July 2011 to March 2015 were reviewed retrospectively.Results One hundred seventy-seven aneu-rysms were detected by DSA, and 175 aneurysms were detected by CTA.Among the aneurysms identified by CTA, 4 aneu-rysms were false positive and the correct detection rate of CTA was 96.6%.One hundred sixty-five aneurysms identified by CTA were confirmed by DSA and the correct diagnostic rate of CTA was 96.5%.CTA failed to detect 6 aneurysms and mis-diagnosed 10 aneurysms.Conclusions The correct detection rate and diagnostic rate of CT angiography ( CTA) in multiple intracranial aneurysms is relatively high.But previous surgery, spasm of the vessels, the size and number of aneurysms, radiologists'experience can influence the accuracy of ( CTA) in the diagnosis of multiple intracranial aneurysms, indicating that we should combine CTA with DSA to avoid the misdiagnosis and missed diagnosis.

Background and purpose:Three-dimensional power Doppler angiography (3D-PDA) is a new technique to investigate the vessels in the organs, but the research in thyroid is limited. The purpose of this research was to investigate three-dimensional power Doppler angiography (3D-PDA) in differentiating malignant from benign thyroid nod-ules.Methods:This study prospectively evaluated 103 lesions in 94 patients who were scheduled for surgery. The patients underwent preoperative 3D-PDA scanning. Analysis of the 3D-PDA characteristics includes blood flow pattern, the num-ber of blood vessels, the shape of vessels, the spatial distribution of the vessels, the existence of rich local blood flow within nodules or in the parenchyma surrounding the nodules. This study also analyzed the difference between the benign lesions and the malignant lesions.Results:There were 50 benign lesions and 53 malignant lesions. The sensitivity and specificity of irregular vessels, the asymmetry spatial distribution, rich local blood flow within nodules or in the parenchyma surround-ing the nodules were 64.2%, 96.0%; 56.0%, 88.0%; 54.7%, 96.0%; 60.4% and 94.0%, respectively. The sensitivity, speci-ficity, positive predictive value, negative predictive value and accuracy of 3D-PDA were 83.0%, 94.0%, 93.6%, 83.9% and 90.3%, respectively.Conclusion:3D-PDA provides a useful tool to investigate vascularization of thyroid leisions.This technique is feasible for clinical application and plays an important role in diagnosis of thyroid nodules.