Objective To study the CT and MRI findings of adenoid cystic carcinoma(ACC) of the head and neck.Methods All 16 cases of ACC were verified by histopathology.Imaging data were analyzed retrospectively.Results The lesion mainly occurred in maxillary sinus in 5 cases,in middle ear and in the floor of mouth in 3 cases respectively,in nasopharynx and parotid in 2 cases respectively,in nasal cavity in 1 case.On CT,the lesion showed ill defined and irregular-shaped soft mass in 6 cases and associated with osteolytic bony destruction in 3 cases.On MR T1WI,the lesion showed isointensity compared to the muscle in 14 cases and slightly hypointensity in 2 cases.On T2WI,the lesion showed isointensity in 6 cases,hyperintensity in 10 cases,heterogeneous intensity in 9 cases.Postcontrast MR imagings demonstrated obvious enhancement in 15 cases,moderate enhancement in 1 case.Lesion with short T2 septum in 7 cases,all of them showed no enhancement.Conclusion CT is the optimal modality in showing osteolytic bony destruction.MRI can demonstrate the invaded extent of the lesions clearly.Combined imaging modalities can provide more comprehensive information in diagnosis and therapy of adenoid cystic carcinoma of the head and neck.

OBJECTIVE:To prepare Coenzyme Q10 long-circulating liposomes,establish the determination method of content and entrapment efficiency,and prepare it into lyophilized preparation to improve its stability. METHODS:Coenzyme Q10 long-cir-culating liposomes were prepared by film dispersion method. Particle size and Zeta potential of liposomes were determined,and HPLC assay was used to determine the content of coenzyme Q10. Free drugs and liposomes were separated using protamine aggre-gation method,and the encapsulation efficiency was calculated. Lyophilized preparation was prepared by coenzyme Q10 long-circu-lating liposomes,and the changes of content and encapsulation efficiency of drugs were determined 0,30 and 90 days after lyophi-lization. RESULTS:The liposomes were homogeneous in size with mean diameter of(166.0±5.3)nm and Zeta potential of(-22.2± 1.4)mV. Average content(the percentage of content accounted for labeled amount)and entrapment efficiency of 3 batches of sam-ple were 98.2%(RSD=2.8%) and 93.2%(RSD=4.6%),respectively. Compared with 0 d after lyophilization,coenzyme Q10 long-circulating liposomes had no obvious change in the content and encapsulation efficiency 90 d after lyophilization. CONCLU-SIONS:Coenzyme Q10 long-circulating liposomes with high quality and entrapment efficiency and lyophilized preparation being stored stably for 90 d have been prepared successfully.

Objective:To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods:(1)From September 2017 to September 2018, 345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC) of Shanghai General Hospital were recruited and included in this research. They were divided into newly-diagnosed type 2 diabetes(duration≤1 year) and long-term groups(duration>1 year). The general characteristics, blood pressures, glycemic levels, lipids levels, control rates and comprehensive compliance rates(blood glucose, pressure and lipids all reached targets) were compared at baseline between 2 groups.(2)All patients underwent one year standardized management, and metabolic indicators mentioned above and control rates at the time were compared as well.Results:(1) At baseline, compared with long-term group, patients in newly-diagnosed type 2 diabetes group were younger ( P<0.01), and 2 h blood glucose level after glucose loading were higher [(15.20±5.26 vs 13.68±4.94) mmol/L, P<0.01]. (2) After one year standardized management, body weight, blood pressure, glucose and lipids metabolism in all patients were significantly improved. Compared with patients in long-term group, newly-diagnosed type 2 diabetes patients achieved better glycemic level [fasting blood glucose(6.27±1.56 vs 7.63±2.08) mmol/L, P<0.01; glycated hemoglobin(6.33±0.96 vs 7.23±1.37) %, P<0.01] , and had higher HOMA-β [(74.01±56.45 vs 40.17±37.07) %, P<0.01]. The glycemic control, blood pressure and blood lipids control rates in both groups increased significantly in one year. Comprehensive compliance rate of the whole patients increased from 5.80% to 24.06%. The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term group[comprehensive compliance rate: (24.73% vs 17.18%, P=0.087, glycemic control rate(84.62% vs 53.37%, P<0.01)]. Conclusion:Standardized metabolic disease management promoted the overall improvement in blood glucose, blood pressure, and lipids levels in type 2 diabetes patients, especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes. In the future, we should focus on the early diagnosis and treatment of type 2 diabetes, actively promote the MMC model and stress the integrated management of blood glucose, blood pressure, and blood lipid levels. We should pay more attention to the long-term patients, to improve their awareness and treatment compliance.

This study was aimed to explore clinical functions of consensus-based clinical practice guidelines (CB CPGs) in traditional Chinese medicine (TCM). Under the guidance of the State Administration of TCM, 42 TCM hospitals in China had conducted a questionnaire survey for 73 CB CPGs and 2993 questionnaires had been included and analyzed. According to the category of good, general and bad, the proportion of the good in improving safety performance was 69.43%, controlling cost was 58.57%, regulating medical behavior was 55.50%, improving clinical effectiveness was 46.74%. It was concluded that the CB CPGs had played a good role in improving safety performance and controlling cost in TCM clinical practice.

Background Idiopathic orbital inflammatory pseudotumor (IOIP) is a commom orbital disease,with serious eye symptoms and replase tendency,and its pathogenesis is still unclear.Nuclear factor-κB (NF-κB)-related proteins participate in many important pathophysiological process,however,whether NF-κB plays a role in the IOIP process is worthy of attention.Objective This study was to explore the roles of NF-κB pathway in IOIP pathogenesis.Methods Twenty-four IOIP specimens were collected during surgery in Beijing Tongren Hospital from September 2010 to May 2016.The histopathological characteristics of IOIP were examined by hematoxylin and eosin staining.The expression and location of NF-κB/p65,p-p65,p50 and inhibitor of κB (IκB-ot) were detected by immunohistochemistry and verified by immunocytochemistry and Western blot assay.Results The histopathological features of IOIP were numerous small lymphocyte infiltraion and fibrous tissue proliferation,and a lot of epithelioid cells were seen in lacrimal gland-involved specimens.NF-κB/p65 was positively expressed in the cytoplasm of all 24 specimens and the nucleus in 15 specimens with the expressing rate of 62.5％.p50 was expressed in the cytoplasm in 22 specimens with the expressing rate of 91.7％ and in the nucleus in 17 specimens with the expressing rate of 70.8％.The positive expression of p-p65 was found in 22 specimens with the expressing rate of 91.7％,and IκB-α was expressed in the cytoplasm of 11 specimens with the expressing rate of 45.8％.These results were confirmed by immunocytochemistry and Western blot assay.Conclusions NF-κB pathway is activiated during IOIP process,and NF-κB pathway may be involved in the pathogenesis of IOIP.

Objective To evaluate the clinical efficacy of Radical TUR-BT combined with intra-arterial chemotherapy in the treatment of stage T2 N0 M0 localized muscle-invasive bladder cancer (MIRC).Methods The clinical data of 91 patients with T2 N0 M0 localized myometrial invasive bladder cancer admitted from January 2010 to December 2015 in the people's Hospital of Xinjiang Uyghur Autonomous Region were retrospectively analyzed,76 cases were males,15 cases were female,average age was 63.2 years old,age range 39-91 years old.Patients were divided into BPT group (n =34) and RC group (n =57) according to different surgical methods.Patients in the BPT group underwent Radical TUR-BT + intra-arterial chemotherapy,and patients in the RC group underwent radical cystectomy + urinary diversion.The median follow-up time,2-year progression-free survival,5-year disease-specific survival rate,overall survival and Karnofsky performance status (KPS) were compared between the two groups.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;and Chi-square test was used to compare the count date between groups.Using KaplanMeier method to depict disease-specific survival time in two groups.Quality of life evaluation using Karnofsky score,Evaluate the quality of life and health status of the two groups 3 months before and after treatment.Results The median follow-up time of BPT group and RC group were 35 months and 33 months.The 2-year progression-free rates in the BPT and RC groups were 73.5％ and 75.4％,respectively,and the difference was not statistically significant (P =0.758).The 5-year disease-specific survival rates of the two groups were 72.4％ and 74.8％,respectively,and the difference was not statistically significant (P =0.780).The overall survival rates of the two groups were 61.8％ and 63.2％,respectively,and the difference was not statistically significant (P =0.103).There was no significant difference in preoperative KPS score between the two groups (P =0.652).The KPS score of the BPT group was significantly higher than that of the RC group at 3 months after surgery.The difference was statistically significant(P =0.034).Conclusions For patients with localized MIBC with clinical stage of T2 N0M0.Radical TUR-BT combined with intra-arterial chemotherapy has similar effects to RC.This treatment can effectively improve the prognosis,preserve the bladder,and improve the quality of life for patients.

Objective To analyze changes in serum levels of inflammatory factors,galectin-3 (Gal-3),fractalkine(FKN) and interleukin-6 (IL-6),in patients with dilated cardiomyopathy (DCM) or ischemic cardiomyopathy (ICM),and to explore their clinical significance.Methods Seventy-six hospitalized patients with DCM were selected to serve as a DCM group,and 78 patients with ischemic cardiomyopathy were selected into an ICM group from October 2016 to December 2017 at the Department of Cardiology,and patients in the two groups received cardiac function classification.Meanwhile,82 healthy people were included as a control group.Fasting venous blood was collected,and serum levels of Gal-3,FKN,IL-6,and BNP were measured.The correlations of Gal-3,FKN,and IL-6 with DCM or ICM were analyzed.Results Levels of plasma BNP and serum Gal-3,FKN,and IL-6 in the DCM and ICM groups were higher than those in the control group,and their levels in the DCM group were significantly higher than in the ICM group.Levels of plasma BNP and serum Gal-3,FKN,and IL-6 increased as their New York Heart Association(NYHA)classification went higher in both the DCM and ICM groups.For patients classified at the same level,serum levels of Gal-3,FKN,and IL-6 of the DCM group were significantly higher than those of the ICM group(P ＜ 0.05).BNP levels showed no difference between the two groups(P ＞0.05).Spearman correlation analysis indicated positive correlations of NYHA classification with levels of BNP(r =0.30,0.19),Gal-3(r=0.24,0.19),FKN(r =0.63,0.51),and IL-6(r =0.28,0.15)in both the DCM and ICM groups(P ＜ 0.05),and the correlation was stronger in the DCM group.Conclusions Increased expression of plasma BNP,Gal-3,FKN,and IL-6 in patients with DCM and ICM are closely related to the severity of cardiac function impairment.Monitoring changes in levels of plasma BNP and serum inflammatory factors Gal-3,FKN and IL-6 provides important clues for the differential diagnosis between DCM and ICM,the assessment of clinical conditions and treatment-related decisions.

Objective To compare the clinical efficacy between bone cement-augmented pedicle screw fixation and bone filling vertebroplasty for stable osteoporotic thoracolumbar burst fracture (TBF).Methods From August 2014 to August 2017,48 patients with stable osteoporotic TBF but no neurological symptoms were treated at Department of Orthopedics,The First Affiliated Hospital to Chongqing Medical University.Those undergoing bone cement-augmented pedicle screw fixation were assigned into Group A while those undergoing bone filling vertebroplasty into Group B.The clinical efficacy was evaluated by comparing visual analogue scale (VAS) for pain assessment,Oswestry disability index (ODI),compression ratio of anterior vertebral height,and cobb kyphotic angle between preoperation and postoperation.The 2 groups were compared in terms of operation time,bone cement consumption,blood loss,hospital stay and relative medical costs.Results Of the 48 patients included in this study,27 were in Group A and 21 in Group B.The 2 groups were comparable as their baseline characteristics were insignificantly different (P ＞ 0.05).At 3 days after operation,the VAS (2.8 ± 1.0) and ODI (26.0 ±3.5) scores for group B were significantly lower than those for group A (4.6 ± 1.3 and 34.3 ± 2.9) (P ＜ 0.05).In group A at 3 months after operation and final follow-up,the VAS (2.9 ±0.9 and 2.3 ±0.7) and ODI (24.7 ±3.1 and 23.1 ±4.6) scores were significantly lower than those at 3 days after operation (4.6 ± 1.3 and 34.3 ± 2.9) (P ＜ 0.05).In group B at 3 months after operation and final follow-up,the VAS (2.8 ±0.9 and 2.3 ± 1.0) and ODI (23.8 ±3.7 and 22.8 ± 5.6) scores were insignificantly better than those at 3 days after operation (2.8 ± 1.0 and 26.0 ± 3.5) (P ＞ 0.05).At 3 days and 3 months after operation and final follow-up,group B had significantly smaller compression ratios of anterior vertebral height (81.1％ ± 3.7％,81.1％ ± 3.4％ and 75.6％ ± 5.8％) than group A did (91.4％ ±4.4％,90.1％ ±2.9％ and 83.5％ ±4.4％) but significantly larger cobb kyphotic angles (17.0° ± 4.0°,18.0° ± 3.5 ° and 22.1 ° ± 3.6°) than group A (14.0° ± 3.2°,14.3° ± 5.5° and 19.2° ± 3.2°) (P ＜ 0.05).The compression ratio of anterior vertebral height and cobb kyphotic angle at the final follow-up in all the patients were significantly improved compared with those at 3 days and 3 months after operation (P ＜ 0.05).Group B had significantly less operation time (51.5 ±7.3 min),blood loss (16.0 ± 8.2 mL),hospital stay (3.4 ±0.9 d) and medical costs per person (34,000 ±4,000 RMB yuan) than group A (91.5 ± 9.8 min,77.4 ± 16.5 mL,8.7 ± 2.2 d and 55,000 ± 9,000 RMB yuan),but significantly larger bone cement consumption (5.1 ± 0.7 mL) than group A (1.9 ± 0.7 mL) (P ＜ 0.05).Conclusion For patients with stable osteoporotic TBF,both bone cement-augmented pedicle screw fixation and bone filling vertebroplasty can lead to similar clinical outcomes,but the latter may have advantages of less invasion,faster recovery and lower medical costs.

External beam radiation therapy (EBRT) is one of the main treatments for prostate cancer, and image-guided implementation of EBRT is more suitable for accurate radiotherapy. As a new type of image-guided technology, the Clarity system has been applied in the real-time tracking during EBRT for prostate cancer in clinical practice. While improving the accuracy of EBRT targeting, it also significantly reduces the side effects of traditional EBRT. In this article, the application of Clarity system in EBRT of prostate cancer and its existing problems were systematically elucidated.

Objective:To explore the potential facilitators and barriers to healthy behavior among stroke patients.Methods:Semi-structured interviews were conducted among 16 stroke patients from September 2022 to March 2023 using an objective sampling method.The interview guide was developed using the theoretical domain framework(TDF). Interviews were transcribed and refined the theme using directed content and induction analysis.Using the TDF as the initial coding framework, the themes were then merged into the most relevant domains.Finally, the correspondence between theoretical domains and the healthy behavior of stroke patients was determined based on the frequency and relationship between themes.Results:This study identified nine theoretical domains that affected the healthy behavior of stroke patients: knowledge, skills, motivation and goals, social influences, social/professional role and identity, environment context and resources, belief about capability, consequence belief and behavioral regulation.Conclusion:The healthy behavior of stroke patients is complex and influenced by several factors.The nine theoretical domains identified in this study will provide recommendations for future healthy behavior interventions for stroke patients.