Adolescent ; Adult ; Barotrauma ; complications ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; etiology ; therapy ; Sinusitis ; etiology ; therapy ; Young Adult

OBJECTIVE To explore the causes, predilection sites and treatment of nasal sinus mucoceles after hypophysectomy.METHODS The clinical data of 7 cases with nasal sinus mucoceles after hypophysectomy diagnosed and treated in our Department from Jan.1998 to Aug.2007 were retrospectively studied.RESULTS The mucoceles were located at ethmoid sinus in 2 cases,frontal sinus in 2 cases,frontal and ethmoid sinuses in 3 cases.All of the 7 cases underwent mucocelectomy under nasal endoscope or a combined endoscopic intranasal and extra-nasal approach.No recurrence was found after follow up for 1 to 3 years.CONCLUSION The causes of nasal sinus mucoceles after hypophysectomy are the change of the anatomic structure of nasal cavity after surgery.The stenosis,adhesion of middle nasal meatus or obstruction of the sinus ostium are found in all the patients.Intranasal endoscopic surgery or combined with extra-nasal approach is the first choice for nasal sinus mucoceles.

Costimulatory signals have become a hot field in immunological researches. As co-inhibitory molecules, programmed death-1 ( PD-1) and its ligands (PD-1/PD-L) have been demonstrated to play an important role in autoimmune disease, organ transplant rejection, microorganism infection, tumor immune escapes etc. . In recent years,some studies about PD-1/PD-L pathway in ophthalmology have been curried out and reported. Some changes were found in PD-1/PD-L pathway, such as ocular immunologic diseases, ocular infectious diseases, ocular tumors, immune privilege in ocular tissues and so on. Through the research on PD-1/PD-L pathway,we can further understand the pathogenesis of some ocular diseases and find new methods for their prevention and treatments. This article reviewed the recent advances in PD-1/PD-L pathway in ophthalmological physiopathology.

Matrix metalloproteinase-9 plays an important role in the blood-brain barrier disruption.Blood-brain barrier disruption may directly influence the neurovascuiar unit repair after cerebral ischemia.An in-depth study of matrix metalloproteinase-9-mediated ischemic brain damage and neurovascular remodeling is expected to open up a new way for the diagnosis and treatment of cerebral ischemia in clinical practice.

OBJECTIVE:To discuss the application of Prescription Automatic Screening System (PASS) in the examination of clinical medical orders. METHODS: The level and type of caution and the modification rate of medical orders in our hospital between April 2005 and April 2006 were analysed statistically, and the conformity between PASS cautions of medical orders and clinical medications was evaluated. RESULTS: A total of 10 982 160 medical orders were monitored by PASS, of which, 11 146 were with black cautions and in which 2 861(25.67%) were modified, 51 504 were with red cautions and in which 10 357 (20.0%) were modified, 339 449 were with yellow ones and in which 66 022 (19.45%) were modified. In PASS monitor process, inconformity between feasible clinical medical orders and cautions of PASS was noted in a few cases. CONCLUSION: The examination of medical orders using PASS is convenient and rapid and the PASS can help improve clinical rational drug use level, however, its function of remains to be updated and optimized.

Objective To investigate the early postoperative rehabilitation condition of patients with cervical spondylotic radiculopathy and analyze its correlation with the life style.Methods A retrospective analysis for 164 cases of cervical spondylotic radiculopathy with complete follow-up data were carried out.Using modified MacNab criteria for evaluation of postoperative recovery.The clinical efficacy was evaluated 3 months after operation,and the patients were divided into satisfactory group (excellent/good) and unsatisfactory group (fair/poor).The influencing factors included general information and the lifestyle such as smoking,drinking,sleep time,the height of the pillow,working time and frequency of physical exercise.The chi-square test and Logistic multivariate regression analysis were used to analyze the effects of lifestyle on early postoperative rehabilitation patients with cervical spondylotic radiculopathy.Results Postoperative efficacy satisfaction of patients evaluated by modified MacNab standard was 88.4％ in 3 months.There were differences in age(x2 =5.819),smoking(x2 =5.074) and frequence of physical exercise(x2 =4.430),and the differences were statistically significant (all P＜ 0.05).Logistic analysis showed that age more than 50 years old(OR=3.913,95％ CI =1.321-11.594,P=0.014),smoking(OR=3.217,95％ CI =1.126-9.195,P =0.029) and frequence of physical exercise less than or equal to 3 times a week (OR=3.906,95％ CI =1.026-14.869,P=0.046) were the risk factors affecting the satisfaction of clinical curative effect of early postoperative cervical spondylotic radiculopathy.Conclusion Age,smoking and physical exercise are related to early postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and then more than 50 years old,smoking and exercise less than 3 times a week have adverse effects on the early postoperative rehabilitation.

Objective To investigate the factors associated with hyponatremia after pituitary adenoma surgery and its prognosis.Methods Clinical data of 120 pituitary adenoma patients treated in our hospital form Jan.2008 to Dec.2010 were retrospectively collected.The incidence of hyponatremia after surgery,clinicopathology and related treatment were analyzed.Results In the 120 patients,28 (23.3％) occurred hyponatremia.The blood natrium concentration recovered to normal in 7 patients within 3 days,and in 21 patients within 4 -7 days.Hyponatremia was associated with age,size of adenoma,type and diabetes insipidus early after surgery(x2 =12.6,12.4,5.38 and 6.51,Ps ＜0.05).Conclusion Hyponatremia after pituitary adenoma surgery is frequent in patients with giant pituitary adenoma,history of diabetes insipidus and older than 50 yrs.Monitoring blood electrolyte and treatment with sodium in 1 - 2 weeks after surgery would be helpful to prevent potential severe compilations.

Objective To explore the effect of linraglutide on expressions of plasminogen activator inhibitor 1 (PAI-1) and intercellular adhesion molecule 1 (ICAM-1) in cultured rat glomerular mesangial cells (RGMCs) stimulated by tumor necrosis factor α (TNF-α).Methods Cultured HBZY21 RGMCs were divided into 6 groups:normal control cells,TNF-α stimulated cells,liraglutide low (10 nmol/L),median (100 nmol/L) and high (1000 nmol/L) concentration incubated cells stimulated with TNF-α,PDTC intervention cells.The expressions of PAI-1 and ICAM-1 of each group were measured by ELISA and RT-PCR.Results The levels of PAI-1 and ICAM-1 protein and mRNA were remarkably increased by TNF-α (P＜0.05),and liraglutide could inhibit above up-regulated expressions (all P＜0.05).Compared with TNF-α-stimulated group,the expressions of PAI-1 and ICAM-1 were decreased by PDTC intervention (all P＜0.05).Conclusion Liraglutide can partly down-regulate the expressions of PAI-1 and ICAM-1 induced by TNF-α in RGMCs.

Objective: To anal yze the reasons for the increasing Chinese residents’ self-medication, and provide references for reasonable positioning and development of self-medication. Methods:Using the National Health Service Survey data (1993, 1998, 2003, and 2008), and use multivariate logistic regression analysis to study the influencing factors of self-medication. Results: Chinese residents’ self-medication have differences in the both time and space dimensions. The influencing factors of medical decision include the demographic characteristics of the diseased residents, medical insurance system, the available of specialized medical services space, family economic conditions, healthy living behaviors, daily health situation, two-week morbidity cognition and two-week morbidity outcomes etc. Conclusion: The alternative function of self-medication determines its reasonable development space. The increasing rate of Chinese residents’ self-medication has many influencing factors.

In recent years, Chinese residents’self-medication has a rapid upward trend. From the perspective of behavioral economics, it analyzes the reasons for the increasing proportion of Chinese residents’self-medication which has been tested by four data of National Health Service Survey, and provides objective understanding reference for the self-medication.