Adolescent ; Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; surgery ; Humans ; Male ; Osteoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery

Objective To analyze CT characteristics of metastatic liver leiomyosarcoma(MLL),and to improve the diagnostic accuracy of MLL.Methods CT manifestations and clinical characteristics of 5 patients with pathological-proved MLL were retrospectively analyzed.Plain and contrast-enhanced triphase(including arterial,portal phase in all cases and delayed phase in a part of cases) scans were performed.Results On plain scan,all lesions were hypo-dense."Bull-eye-sign" was found in two cases on contrast-enhanced scan,which is the typical metastatic feature.During arterial phase,the smaller lesions showed marked peripheral enhancement and central necrosis.The larger MLL presented as solid-cystic lesions,the parenchyma of tumor was rich in blood supply.Some cases presented mild hypo-dense or iso-dense comparing with the parenchyma of the liver on delayed phase.One case was misdiagnosed as hepatic hemangioma or focal nodular hyperplasia(FNH).Metastases were found out of the liver.Tumor thrombus of portal vein was not found in all of the cases.Conclusion MLL should be considered in the patients with history of extra-hepatic leiomyosarcoma,no marker expressions,no history of hepatitis,no tumor thrombus of portal vein and the special CT findings.

Objective To investigate the diagnostic value of ultrasonography for neck lymph node metastasis in papillary thyroid carcinoma(PTC) and Hashimoto's thyroiditis(HT) coexistent with PTC.Methods Two hundred and seventy-eight patients who accepted thyroid surgery were retrospectively reviewed for the pre-operative ultrasonographic and post-operative pathological reports.All patients were confirmed as PTC by surgery and pathology.According to the presence of HT confirmed in pathology,all patients were divided into two groups:group of PTC and group of HT with PTC.The status of neck lymph node metastasis and the diagnostic value of pre-operative ultrasound in detecting neck lymph node metastasis were studied.Results There were 185 cases in the group of PTC,and the rate of neck lymph node metastasis was 59.5 ％;while there were 93 cases in the group of HT with PTC,in which the rate of neck lymph node metastasis was 45.2％.The difference between the two groups in lymph node metastasis was statistically significant (P =0.024).The predictive accuracy of pre-operative ultrasound for central neck lymph node was 53.9％ in the group of PTC,which was statistically higher than 18.8％ in the group of HT with PTC(P =0.01).The predictive accuracy of pre-operative ultrasound for lateral neck lymph node was 79.4％ in the group of PTC,which had no statistical difference with that in the group of HT with PTC (73.1％,P =0.565).Conclusions The neck lymph node metastasis in PTC patients occurs more frequently than that in PTC patients with HT.The value of pre-operative ultrasound examination is lower for the detection of central lymph node metastasis,especially in PTC patients with HT;while ultrasound is more sensitive and accurate for lateral lymph node detection regardless of the existence of HT.

Objective To assess the clinical efficacy and safety of paroxetine combined with low dosage of amisulpride on the treatment of somatoform disorders. Methods A total of 67 somatoform disorders patients were randomly divided into treatment group ( n=33 ) and control group( n =34 ) .Patients in the treatment group were given paroxetine combined with amisulpride treatment , paroxetine 20 mg? d-1 initially and adjusted to 20 -60 mg? d-1 within 1 week; amisulpride 50 mg? d-1 initially and adjusted to 100 -150 mg? d-1 within 1 week. And patients in the control group were given paroxetine as the same schedule of treatment group combined with placebo .The HAMD, HAMA and SCL-90 score were used to evaluate the symptoms before and at the time of 2, 4 and 6 weeks after treatment .Results The HAMD, HAMA and SCL -90 score were ( 19.52 ±2.98 ) , ( 22.64 ±3.42 ) and (3.01 ±0.72) in treatment group and (20.38 ±3.25),(21.87 ±3.31) and ( 2.82 ±0.68 ) in control group without statistical difference (P>0.05).After6weekstreatment,thescorewere(8.36±2.67),(9.38±2.23),(1.20±0.52)intreatment group and (11.33 ±3.02), (11.62 ±2.66), (1.67 ±0.59) in control group with statistical difference (P<0.05). The HAMD score was significantly decreased in the treatment group compared with control group 2 weeks after treatment ( P<0.05 ) .The HAMA and SCL-90 score in treatment group showed significant differences after 4 weeks treatment and especially 6 weeks later compared with control group (P<0.05).The total incidence of adverse drug reactions was 33.33% in the treatment group and 26.47% in the control group with no difference ( P >0.05 ) . Conclusion Paroxetine combined with low dosage of amisulpride can improve the symptom quickly for the treatment of somatoform disorders , without increasing adverse reactions .

OBJECTIVETo develop dataset for basic medical information system.

METHODSAll items of basic medical information system dataset were drafted by literature review, brain storm and group discussion. A Delphi study was conducted to evaluate and adjust the candidate items; then items were finalized based on comprehensive scores.

RESULTSThe final dataset developed through two-round Delphi study contained 20 first-level items, 102 second-level items, 40 third-level items and 88 fourth-level items. The response rates were 71.79% and 92.86% in round 1 and 2, respectively. The authority coefficient was both 0.77 and the coordination coefficient of the specialists' opinion was 0.239 and 0.516, respectively.

CONCLUSIONThe dataset for basic medical information system determined from Delphi study is credible and can be used for development of related software.

Objective To compare the application effects of three methods,namely microscopic examination,antigen detec-tion(RDT)and nucleic acid test(PCR)in malaria detection between municipal and districts/counties centers for disease con-trol and prevention in Shanghai,and analyze the malaria detection ability of the laboratories in Shanghai. Methods The blood smears,whole blood samples,case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention,and the detection results were analyzed and compared. Results A total of 212 samples with complete data were submitted by all districts(counties)in Shanghai from 2012 to 2015,the samples submitted by Jinshan Districts were the most(41.98%),and among the first diagnosis hospitals,those submitted by the tertiary hospitals were the most(82.07%). The submitted samples in the whole year were in-creased gradually from January to October. All the 212 samples were detected by three methods(the microscopic examination, RDT and PCR)in the laboratory of Shanghai Municipal Center for Disease Control and Prevention,and 167 were tested and con-firmed comprehensively as positives,accounting for 78.77%,and 45 were confirmed as negatives,accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level,totally 153 were tested as positives,accounting for 72.17%,41 were unclassified,account-ing for 19.34%,53 were negative,accounting for 25.00%,and 6 were undetected,accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%,and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests be-tween those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention,37 samples were misjudged by the laboratories of district/county level. Almost all(99.37%)of the confirmed malar-ia cases were imported overseas,including Africa(85.44%),Asia(13.92%)and America(0.63%). Conclusion The surveil-lance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource in-tegration.

Objective: To explore if conventional protein kinase C (cPKC: PKCα and PKCβ) contributes to paraquat (PQ) -induced abnormal permeability of mouse brain microvascular endothelial cells (BMECs) via the regulation of tight junction (TJ) proteins. Methods: The immortalized mouse brain endothelial cell line (bEnd.3) was used to establish a monolayer blood-brain barrier (BBB) model. In order to evaluate the function of the in vitro BBB model, the transendothelial electrical resistance (TEER) and permeability were measured by a Millicell-ERS volt-ohmmeter and sodium fluorescent (Na-FLU) , respectively. MTT assay was used to determine the relative survival rate of cells. The dose-response relationship was determined by treating cells with 0, 50, 100, 200, and 300 μmol/L PQ for 24 hours. The time-response relationship was determined by treating cells with 200 μmol/L PQ for 6, 12, 24, 48, and 72 hours. After the treatment of cells with 0, 100, 200, and 300 μmol/L PQ for 24 hours, the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were measured by immunofluorescence (IF) and quantitative real-time RT-PCR (qRT-PCR) , respectively; the expression of PKCα, PKCβ, phosphorylated (p) -PKCα, and p-PKCβ was determined by Western blot. After the treatment of cells with 200? mol/L PQ for 24 hours following the pretreatment with a classical PKC inhibitor (Go 6983, 1 μmol/L) for 1 hour, the protein expression of ZO-1, Occludin, Claudin-5, p-PKCα, and p-PKCβ was measured by Western blot. Results: The TEER of the bEnd. 3 cells increased gradually with the cell culture time, and reached a peak value of 114.3±6.9 Ω·cm² on day 6. According to the permeability analysis by Na-FLU, cell permeability gradually decreased with the cell culture time, and reached 1.7±0.2 cm/min on day 6, suggesting a well-behaved barrier function of cells. Compared with the control group, the survival rates of the bEnd.3 cells were significantly reduced after exposure to 100, 200, or 300 μmol/L PQ for 24 hours (P<0.05) , or after exposure to 200 μmol/L PQ for 6, 12, 24, 48, or 72 hours (P <0.05) , indicating a dose-and time-dependent relationship. The IF and qRT-PCR results showed that the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were significantly reduced with the increase in the concentration of PQ (P<0.05) . The Western blot analysis showed that compared with the control group, cells exposed to PQ had significantly higher protein expression of p-PKCα and p-PKCβ and significantly lower protein expression of ZO-1, Occludin, and Claudin-5 (P<0.05) . Compared with the PQ treatment group, the Go 6983 intervention group had significantly higher protein expression of ZO-1, Occludin, and Claudin-5 and significantly lower protein expression of p-PKCα and p-PKCβ (P<0.05) . Conclusion By activation of cPKC (PKCα and PKCβ) , PQ reduces the protein and mRNA expression of TJ proteins and enhances the permeability of murine BMECs.

Objective: To investigate the impacts of paraquat on microRNA profiles in apoptosis of human neural progenitor cells (hNPCs) and to explore miRNA targets and biological functions. Methods: We used hNPCs as a popular in vitro cell model system for characterizing the neurotoxicity. Cell apoptosis was detected by Annexin V-APC/7-AAD after 24 h treatment with different concentrations of PQ (0, 5, 10, 20, 40, 80 μmol/L). Microarray profiling expression of PQ treated cell line and their corresponding control was determined and differentially expression miRNAs were confirmed by quantitatively real-time PCR. The target genes regulated by aberrantly expressed miRNAs were predicted by on line-available software (Target Scan, Miranda, Mirbase). The GO and KEGG pathway database were used to analyze the functions of target genes. Meanwhile, the apoptosis-related protein expressions were evaluated by western blot. Results: cell apoptosis increased with increasing PQ concentrations (from 10 to 80μmol/L) in a dose-dependent manner (P<0.05). miRNA microarray showed that 40 miRNAs were significantly up-regulated while 26 miRNAs were down-regulated after 20 μmol/L PQ treatment (P< 0.05). We selected 6 differentially expressed miRNAs to validate with qRT-PCR. The results were consistent with microarray data for all miRNAs tested. Bioinformatics analysis demonstrated target genes were enriched in regulation of neuron apoptosis and differentiation, MARK signaling pathway as well as P53 signaling pathway. The protein expressions of bax and caspase3 significantly increased while bcl-2 significantly decreased treated with PQ compared with control group (P<0.05). Conclusion There is a specific miRNA expression profile in paraquat-induced apoptosis of hNPCs. Differentially expression miRNAs regulated apoptosis of hNPCs through multiple molecular signaling pathways and especially for mitochondrial apoptosis pathway.

Objective To investigate the effect of Porphyromonas gingivalis(Pg) with different fimA genotypes on vascular cell adhesion molecule-1(VCAM-1) and intercellular adhesion molecule-1(ICAM-1) production by human umbilical vein endothelial cells(HUVEC). Methods In the present study, PgATCC33277(type Ⅰ fimA genotype), WCSP 115(type Ⅱ fimA genotype), W83(type Ⅳ fimA genotype), and Escherichia coli-lipopolysaccharide (Ec-LPS) were designed as experimental group 1, 2, 3, and positive control group, respectively, to stimulate HUVEC, and the un-stimulated HUVEC were analyzed as negative control group. The three strains of Pg were cultured anaerobically in standard condition, and then the Pg cells and Ec-LPS were co-cultured with HUVEC for 2, 6, and 24 h, respectively. The amount of ICAM-1 and VCAM-1 produced by HUVEC was detected with flow cytometry(FCM). The expression of ICAM-1 and VCAM-1 by HUVEC were assayed with confocal laser scanning microscope(CLSM). ResultsThe expression of ICAM-1 on the surface of HUVEC were intensified after infected by Pg with Ⅰ, Ⅱ, and Ⅳ fimA genotypes (P<0.05). The amounts of ICAM-1 were 60.27±5.43, 80.81±1.44, and 85.94±2.56 for Pg with type Ⅰ fimA genotype, 86.69±8.81, 90.19±0.00, and 96.18±0.48 for Pg with type Ⅱ fimA genotype, 59.66±0.40, 85.79±4.86, and 96.04±2.07 for Pg with type Ⅳ fimA genotype at 2, 6 and 24 h after infection, respectively. The up-regulation effects caused by Pg with type Ⅱ and Ⅳ fimA genotypes were stronger than those caused by Pg with type Ⅰ fimA genotype at different time points except at 2 h(P<0.05). Under the present experimental condition, infected by Pg with type Ⅰ, Ⅱ and Ⅳ fimA genotypes stimulated low expression of VCAM-1 by HUVEC, it showed no significant differences among all the groups (P>0.05). Expression of ICAM-1 and VCAM-1 in Pg infected HUVEC were confirmed by CLSM. Infection of HUVEC with Pg resulted in more fluorescence staining of ICAM-1 and VCAM-1 compared with that in uninfected HUVEC cultures. Conclusions The virulence and pathogenicity of Pg is associated with its fimA genotypes, Pg with type Ⅱ and Ⅳ fimA genes possess stronger ability to stimulate HUVEC to up-regulate the expression of cell adhesion molecules, which may lead to disorders in vascular endothelial function.

OBJECTIVETo evaluate and compare mail and meeting forms in evaluation of Delphi study.

METHODSDelphi study by mail and meeting approaches was used to determine the health information dataset. Experts were required to grade the listed items through three indexes: importance, necessity and availability. Study duration, coefficient of variation of items, authority coefficient and coordination coefficient of the experts' opinion of two forms of study were calculated and compared.

RESULTThe study duration was four months through mail form and 2 days through meeting. Compared with the first round, the coefficient of variation decreased (P<0.001, all of the three indexes by two forms), and the cooperation index increased (P<0.005) in the second round. The experts' opinions were easier to be consistent through meeting than through mail(P<0.033). And the authority coefficient by meeting consultation (0.83 ± 0.05) was higher than that by mail (0.77 ± 0.03) (P=0.001).

CONCLUSIONBoth mail and meeting forms of Delphi study can determine the health information dataset,but meeting consultation is better and requires shorter study duration.