Objective: To evaluate the application of two-dimension and color Doppler ultrasound in diagnosis and differential diagnosis of fascial space infection in maxillofacial region. Methods: Retrospective analysis was conducted on 87 cases of maxillofacial space infections, among which there were 6 suspected cases of accompanying tumor.Results: In the 87 cases, 53 had abscess formation, confirmed by operative drainage or puncture biopsy. The pathological studies revealed 2 cases of Non-Hodgkin's lymphoma, and 1 case of branchial cleft cyst accompanied with infection. The 3 cases showed characteristic appearance in ultrasonic imaging. The space infection presented stronger echogenicity than that in tumors. In this study, 95% (83/87) cases showed grey or medium echogenic dots, while 4.5% (4/87) cases did not show obvious echogenic dots due to a large amount of abscess, and 2 cases of tumors, however, did not show any echogenic dots. In addition, 87% (76/87) cases had few blood flow in the lesion areas, and 22% (2/87) cases had much blood flow in the lesion areas. All cases showed that the lesion areas and the blood flow reduced obviously with enhanced echo following anti-inflammatory treatment except 2 cases accompanied with tumor without obvious changes in lesion areas and blood flow.Conclusion: The ultrasonic diagnosis with two dimension and color Doppler ultrasound has high accuracy in diagnosis of maxillofacial space infection, with accordance rate up to 96.6%, much higer than CT/MRI. It is suggested that the two dimension and color Doppler ultrasound can be used as a prior choice of diagnosis.

砄bjective: To study the complications of interventional therapy in maxillofacial region. Methods : Retrospective analysis was conducted in 73 cases(96 times) treated with interventional therapy in maxillofacial region. Intraarterial angiography, drug infusion and embolization were conducted in 71 cases of maxillofacial tumor and 2 cases of injury by Seldinger method. Results: Complications with clinical significance occurred were observed in 6 cases (6.2%): allergic reaction to angiographic agent in 2 cases, necrosis of skin in 1, local pain in 1, facial paralysis in 1 and death because of brain damage in 1. 5 cases were cured. Conclusion: The most serious complication in maxillofacial interventional therapy is nerve injury, which may result in death . Certain measures should taken to prevent or reduce the reaction.

Objective: To review the effect of the treatment of maxillofacial and cervical tumor with external cervical atery intervention technique(ECAI). Methods: 92 cases of maxillofacial and cervical tumor were treated with ECAI. Therapeutic embolization was conducted in 30 cases, arteroy perfusion in 42 and opacification in 20. The patients were cared psycologically befor operation, monitored carefully in operation, especially for contrast medium responsing, antitumor drug responsing,embolisming responsing, etc. Results: Permanent embolization was achieved in 5 cases of hemangioma, bleeding was reduced by 75% in 25 cases treated with subsidiary embolization, local and general condition was improved in 32 patients with malignant tumor by perfusion of antitumor drug. Accuration of angiography was achieved in 93% of the cases. Complications were found in 7 cases and cured after treatment but in 1 who died of cerebrovascular disease. Conclusion: Perioperative monitoring is important to eliminate complications of ECAI.

Background: Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome. Objective: To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome. Design, setting, participants and interventions: A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min. Main outcome measures: The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated. Results: The therapeutic effect experienced by the treatment group was better than that of the control group (P<0.05). There were no statistically significant differences in TAS and ETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (P<0.05, P<0.01). There were statistical differences in TAS absolute difference and TAS relative difference between the two groups and the treatment group had better results (P<0.05, P<0.01). After treatment, patients in the treatment group had higher scores in ETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported. Conclusion: Wrist-ankle acupuncture can relieve the symptoms of pre-exam anxiety syndrome significantly, and this therapy is highly safe.

Objective To investigate the effect of norcantharidin on growth inhibition and induction of apoptosis of human rectal cancer Colo 320 cells. Methods Norcantharidin (NCTD) in different concentrations were added to rectal cancer Colo 320 cells. Morphological characteristics of apoptosis were observed using the light microscope and transmission electron microscope. The expressions of Bag-1 and Bcl-2 proteins were tested by Western blotting. The growth inhibition of Colo 320 cells on the cell cycle was observed by flow cytometry. Results The apoptosis morphological changes of Colo 320 cells were observed by the light microscope and transmission electron microscopy. Flow cytometry analysis showed that the cell count of G2/M phase in experimental group was higher than that in control group ( <0.05) but the cell counts of G0/G1 and S phases have decreased in experimental group after treatment with NCTD at the concentrations of 5μg/mL, 10μg/mL and 20 μg/mL, and presented dosage dependence relations. The expressions of Bag-1 and Bcl-2 proteins have decreased. Conclusion Norcantharidin has inhibitory effect on rectal cancer Colo 320 cells, and the effect may be related to the cell cycle arrest and apoptosis.

Objective:To explore the type distribution and severity of central nervous system(CNS) complications in severe hand, foot and mouth disease (HFMD) cases prior to the introduction of human enterovirus A group 71 type (EV-A71) vaccine, and provide scientific data for early clinical intervention.Methods:A total of 3 583 laboratory-confirmed severe HFMD cases in Jiangsu province during 2010-2016 were collected and analyzed retrospectively. Related early warning signs of increased HFMD severity were estimated with logistic regression analyses.Results:The severity-fatality rate, severity-pediatric intensive care unit(PICU) admission rate, and sequelae rate were 8.09‰(29/3 583), 11.75% (421/3 583)and 5.30‰(19/3 583). Of them, 39.02% (1 398/3 583) patients suffered from mild CNS involvement, 59.22% (2 122/3 583) patients suffered from severe CNS involvement, 1.76%(63/3 583) suffered from critical CNS involvement. The rates of the cases whose age of onset was 6-11 months, the rates of cases with atypical rash, respiratory-related signs and symptoms (shortness of breath, slowed breathing, dyspnea, etc), neurological-related signs and symptoms [(hand and foot shaking, convulsions, lethargy(sleepiness), etc], circulatory-related system signs and symptoms (faster heart rate, abnormal skin color, arrhythmia, cold limbs), laboratory-related indicators (increased white blood cell count, increased lymphocyte count, increased platelet count, increased C-reactive protein, etc), clinical auxiliary examination [electroencephalogram(EEG), brain CT, chest X-ray)] were highest in the critical CNS involvement group, and the differences were significant ( P<0.05). Multivariate logistic regression analysis showed that with the increase of proportion of convulsions, slowed breathing, vomiting, meningeal irritation and other 7 variables, the severity of CNS complications increased ( P<0.05). Conclusions:The indicators such as easily startled, slow breathing, vomiting, elevated lymphocytes, abnormal EEG and other indicators have important clinical significance for children with severe HFMD to progress to CNS complications of different severity.

Objective:To screen 89Zr-labeled anti-epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) monoclonal antibody molecular probes suitable for monitoring the gastric mucinous adenocarcinoma bearing mouse models with low glucose metabolism. Methods:The expression of EGFR and HER2 in the MGC803 gastric cancer cell line was verified by analyzing cell slides and xenograft tumor sections. 89Zr-Deferoxamine (DFO)-Cetuximab and 89Zr-DFO-Pertuzumab were prepared and the radiochemical purity was detected. Cell binding experiments and blocking experiments were performed to verify the binding ability and specificity of the probes. Twelve gastric mucinous adenocarcinoma bearing mouse models were divided into 3 groups ( n=4 in each group): 89Zr-DFO-Cetuximab group (7.4 MBq/mouse, 74 μg/mouse), 89Zr-DFO-Pertuzumab group (7.4 MBq/mouse, 70 μg/mouse) and 18F-fluorodeoxyglucose (FDG) group (7.4 MBq/mouse). MicroPET imaging was performed at 4, 24 and 48 h ( 18F-FDG group underwent imaging at 1 h only) post-injection. The biodistribution study of 89Zr-DFO-Cetuximab and 89Zr-DFO-Pertuzumab was conducted in 2 groups ( n=4 in each group) 48 h after the injection. The independent sample t test was used for data analysis. Results:The immunofluorescent staining demonstrated EGFR expression was significantly higher than HER2 expression in MGC803 gastric cancer cell line. The radiochemical purity of 89Zr-DFO-Cetuximab and 89Zr-DFO-Pertuzumab were both more than 95%, and the specific activities were 100 and 95 MBq/mg, respectively. The two probes had good stability in normal saline and fetal bovine serum, with the radiochemical purity higher than 80% at 72 h. MicroPET imaging showed that the uptake of 89Zr-DFO-Cetuximab in the MGC803 tumor was significantly higher than that of 18F-FDG and 89Zr-DFO-Pertuzumab. The biodistribution study demonstrated the 89Zr-DFO-Cetuximab uptake (percentage activity of injection dose per gram of tissue, %ID/g) of tumors at 48 h was significantly higher than that of 89Zr-DFO-Pertuzumab (56.3±12.0 vs 22.0±3.6; t=4.31, P<0.05). Conclusion:Compared with 89Zr-DFO-Pertuzumab, 89Zr-DFO-Cetuximab has a better potential for non-invasive monitoring of gastric mucinous adenocarcinoma with low glucose metabolism.