Antibodies, Monoclonal, Humanized ; therapeutic use ; Bevacizumab ; Electrocoagulation ; methods ; Endoscopy ; Epistaxis ; therapy ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Telangiectasia, Hereditary Hemorrhagic ; therapy

Diagnostic Errors ; Female ; Humans ; Maxillary Sinus ; pathology ; Melanoma ; diagnosis ; Middle Aged ; Paranasal Sinus Neoplasms ; diagnosis ; Polyps ; diagnosis ; pathology

Objective To analyze the relationship between complement key component C3,C4 and the severity of sepsis in children,in order to explore the role of complement activation in the progression of sepsis and provide a reference for diagnosis and treatment of severe sepsis.Methods Four hundred and twenty-four children diagnosed as sepsis from December 2012 to December 2015 in Children's Hospital of Nanjing Medical University were enrolled in this study,among whom 347 children with sepsis were eligible for the following research including 169 cases of common sepsis and 178 cases of severe sepsis.Blood specimens were collected in 24 hours after their admission into pediatric intensive care unit(PICU) for the analysis of lymphocyte subsets,humoral immunity,blood routine analysis,coagulation,liver and renal function analysis.General information was collected by consulting their medical records,laboratory analysis and clinical treatment.The relationship between complement C3,C4 and the severity of sepsis was analyzed,and the correlation between C3 and coagulation,liver,renal,myocardium damage was also studied.Logistic regression was used to analyze the relationship between C3 and the progression to severe sepsis and multiple organ dysfunction syndrome(MODS),while Cox regression was used for survival analysis.Results Natural killer(NK) cell percentage was lower in severe sepsis group than that in common sepsis group [6.6％ (3.7％,10.7％) vs.8.5％ (4.7％,13.3％),Z =2.635,P =0.008],while C3 decreased in severe sepsis group compared with common sepsis group [0.653 (0.462,0.985) g/L vs.0.991 (0.678,1.265) g/L,Z =5.684,P ＜ 0.001],and C4 decreased in severe sepsis group compared with common sepsis group [0.160(0.102,0.244) g/L vs.0.190(0.121,0.265) g/L,Z =2.513,P =0.012].The proportion of severe pneumonia was higher in severe sepsis group than that in common sepsis group (34.3％ vs.19.5％,x2 =9.540,P =0.002),and liver function damage proportion was increased in severe sepsis group than that in common sepsis group (48.3％ vs.16.0％,x2 =41.28,P ＜0.001),and the duration of PICU treatment was longer in severe sepsis group than that in common sepsis group[10.7(6.5,17.4) d vs.7.5(4.0,12.4) d,Z =-4.039,P ＜0.001].C3 was significantly decreased in children with single organ dysfunction,multiple organ dysfunction and death group compared with common sepsis group (K =33.04,P =0.001),and the median of each group decreased with the severity of sepsis,but C4 had no difference among 4 groups (K =7.36,P =0.061).C3 was positively correlated with coagulation marker platelet (p =0.31,P ＜ 0.001) and fibrinogen (ρ =0.53,P ＜ 0.001),but negatively correlated with international normalized ratio (INR) (ρ =-0.39,P ＜ 0.001) and activated partial thromboplastin time (p =-0.34,P ＜ 0.001).C3 was also negatively correlated with liver damage marker alanine transaminase (ρ =-0.30,P ＜ 0.001) and total bilirubin (ρ =-0.28,P ＜ 0.001),and had a negative correlation with renal function marker creatinine (p =-0.24,P ＜ 0.001) and myocardial damage marker creatine kinase-MB (p =-0.27,P ＜ 0.001).The depletion of C3 was a risk factor of severe sepsis(OR =3.45,P ＜ 0.001) and MODS(OR =3.03,P =0.005) after being adjusted for confounding factors by using Logistic regression.In stratification analysis,C3 depletion was still a risk factor of severe sepsis (OR =2.78,P =0.019) and MODS (OR =3.57,P =0.015) among children less than 1 year old,and was also a risk factor of severe sepsis(OR =4.76,P =0.008) among children more than 1 year old as well.In children without liver function damage,C3 depletion was still a risk factor of severe sepsis(OR =4.17,P =0.002) and MODS(OR =9.09,P =0.002).Cox regression showed that C3 depletion was a hazard in 28-day mortality (HR =3.57,P =0.026) in children with sepsis.Conclusion The decrease of C3 is correlated with coagulation dysfunction and organ damage marker,while C3 depletion was a risk factor of severe sepsis,MODS and 28-day mortality,and could be a potential prognostic marker of children with sepsis.

Objective:To investigate the influence of single nucleotide polymorphisms (SNP ) of cytidine deaminase (CDA)in the curative effect of gemcitabine,and to clarify the correlation of CDA SNP with the clinical prognosis of the advanced non-small cell lung cancer (NSCLC)patients.Methods:CDA 79A>C gene was detected by Sequenom Massarray Genotype System among 93 patients with advanced NSCLC who received chemotherapy of gemcitabine.The associations between CDA 79A>C polymorphisms and progression free survival (PFS)and overall survival (OS)were estimated using Kaplan-meier methods and Log-rank test for univariate analysis, and COX proportional hazards model was used for multivariate analysis.Results:There was no significant correlation between the CDA 79A>C SNPs with the clinical and pathological characteristics of NSCLC patients.The median PFS in the patients with wild genotype A/A was 9.3 months, while the median PFS in the patients with mutant genotype A/C and C/C was 11 months;there was no significant difference between them (P=0.061).The median OS in the patients with wild genotype A/A was 2 1.7 months, and the median OS of the patients with mutant genotype was 22.1 months;there was no significant difference between them (P=0.513).Conclusion:CDA 79A>C SNPs can prolong the PFS of the NSCLC patients,but it does not affect the OS of the patients.

Objective:To select the differentially expressed vascular smooth muscle cell(VSMC) apoptosis gene induced by icariin,glucose regulated protein 78(GRP78),to observe the expression of GRP78 in atherosclerosis tissue and to the elucidate the mechanism of anti-atherosclerosis of icariin.Methods:The model was established by using halfcystine in viro.The vascular smooth muscle cell was incubated with various concentrations of icariin for 48 hours.The apoptosis was detected by TUNEL assay.GRP78 gene was amplificated by PCR,recombinant plasmid were constructed,transfected into E.coli,positive clonings were selected and conf irmed by restriction endonucleas analysis,and sequence-ed.Tissue situ hybridization was used to observe the GRP78 expression in atherosclerosis tissue.Results:Icariin promoted obviously vascular smooth muscle cell apoptosis.Furthermore,the fragment,648bp,was similar to the gene of GRP78 from VSMC,and the expression level was signif icantly higher in high cholesterol group than in control nroup.Conclusions:The GRP78 plays a key role in inducing atherosclerotic lesions.The mechanism of anti-atherosclerosis of icariin might be partly due to promoting apoptosis of vascular smooth muscle cell.

Foreign bodies in the paranasal sinuses are rare. Foreign bodies in the ethmoid sinus are easily misdiagnosed as tumor. There is no typical display in CT and MRI tests. The described case showed the misdiagnosis of an ethmoid foreign body as tumour on the basis of CT and MRI results. It should be emphasised that the tumour diagnosis should be based on further physical and histopathological examinations and not only on the results of CT and MRI tests.
Adult ; Diagnostic Errors ; Ethmoid Sinus ; Foreign Bodies ; diagnosis ; Humans ; Male ; Paranasal Sinus Neoplasms ; diagnosis

OBJECTIVE: To evaluate the transsphenoidal endoscopic endonasal approach for the surgical treatment of pituitary apoplexy (PA). METHOD: A retrospective analysis was conducted over the clinical data of 42 pathologically diagnosed of PA after transsphenoidal endoscopic endonasal approach for the resection. CT scan, MRI scan and endocrinological examinations were performed in all case before operation. Glucocorticoids were used during perioperatve period. The postoperation symptoms and the results follow-up visit after operation were recorded. RESULT: The tumors were totally removed in 36 cases and subtotally removed in 6 cases. In follow-up period from half a year to 13 years, headaches were resolved in 100%, visual interference were resolved in 91.9%, pituitary dysfunction were resolved in 77.3%. Without operative death and serious complications. No patient recurred. CONCLUSION We concluded that the transsphenoidal endoscopic endonasal approach is a safe, effective and microsurgery treatment of PA.
Adenoma ; Endoscopy ; Glucocorticoids ; Headache ; Humans ; Magnetic Resonance Imaging ; Microsurgery ; Neoplasm Recurrence, Local ; Pituitary Apoplexy ; surgery ; Pituitary Neoplasms ; Postoperative Period ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To explore the olfactory abilities in patients with allergic rhinitis (AR), analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with AR. METHOD: One hundred patients with AR were compared with one hundred controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). T&T testing and MRI were done after a year in 100 AR patients,the results were compared with the initial results. RESULT: The OB volume in AR patients was (29.53±3.95) mm3 on the left, (29.67±14.21)mm3 on the right, (29.61±4.05) mm3 on average; The OB volume in controls was (48.93±6.73)mm3 on the left side, (48.81±7.43)mm3 on the right side, (48.85±7.11)mm3 on average; The OB volume in AR patients was less then the control group(t= 6.321, 6.141, 6.221, P<0.01). The OS depth had no statistical difference between AR patients and controls (t=1.032, 0.972, 0.991, P>0.05). Olfactory discriminate threshold was negatively correlated with OB volume in AR patients (r=-0.46, P<0.05); and it was no correlated with depth of OS (r=-0.012,P>0.05). Among 100 followed-up AR patients, 43 showed increased in OB volume and olfactory function after a year, but there was no statistical difference (t= 0. 811,0. 843, 0.826, P>0.05; Z=1.911, P>0.05) ,and the other 57 showed no significant changes of OB volume and olfactory function. CONCLUSION In AR patients, the OB volume and olfactory function decreased, but the depth of OS had no significant changes. The OB volume is correlated with olfactory function, while the depth of OS is no correlated with olfactory function. Conservative treatment had some clinical significance on the recovery of olfactory function in patients with AR.
Humans ; Magnetic Resonance Imaging ; Olfaction Disorders ; etiology ; Olfactory Bulb ; pathology ; physiopathology ; Prefrontal Cortex ; Rhinitis, Allergic ; complications ; Smell

目的探讨康复指导对发育性髋关节脱位患儿术后康复的作用。方法在术前和术后,根据手术特点,对48例(63髋)发育性髋关节脱位患儿进行髋关节康复指导。结果经1—2.5年随访 ,48例患儿(63髋)的康复优良率达95%。结论康复指导可促进发育性髋关节脱位患儿术后髋关节的康复。

BACKGROUND: Documents recorded that the correlation between micro emulsion Ciclosporin peak concentration (C_2) and area under curve was best with maximum individual difference. According to C_2, dose of Ciclosporin can be adjusted indMdually to decrease acute rejection and Ciclosporin toxicity, which has widely used in perioperative stage of renal transplanted recipients. However, some transplantation center still used tough concentration (C_0) to adjust the dose of Ciclosporin in stable stage of renal transplanted recipients. OBJECTIVE: To analyze the efficacy and safety of changing from monitoring C_0 to C_2 in stable stage recipients following renal transplantation. METHODS: Totally 65 patients with renal transplantation were enrolled in this study, including 31 males and 34 females, aged 20-57 (39.4±15.3) years. Within 3 months prior to this study, all patients did not suffered from rejection, and their serum creatinine and urea nitrogen were stable (creatinine ≤180 μmol/L). They were in stable stage after renal transplantation. Their period of transplantation and function of allograft were recorded. Their C_0 and C_2 of Ciclosporin were assayed. According to the target C_2 value 500-600 μg/L, the patients were prospectively and randomly divided into 3 groups. In the high C_2 group (n=17), the dose of Ciclosporin was decreased. In the target C_2 group (n=23), the dose of Ciclosporin was remained. In the low C_2 group (n=25), the dose of Ciclosporin was increased. All of the patients were followed-up for 12 months. The grafts function and the complications of heart, lung and brain were compared. RESULTS AND CONCLUSION: According to the target concentration of Ciclosporin C_2, the dose of Ciclosporin in the high C_2 group was decreased by 575.0 mg. The Creatinine and urea nitrogen of 88% patients were stable, while blood pressure, blood fat and blood uric acid decreased in parts of patients. In the target C_2 group, the levels of creatinine, urea nitrogen, Co and C_2 of patients were stable, no complications of heart, lung and brain occurred. According to the target concentration of Ciclosporin C_2, the dose of Ciclosporin in low C_2 group was increased by 755.0 mg. The creatinine and urea nitrogen of 84% patients were stable. All of the patients were no complications of heart, lung and brain. It is safe and effective to adjust Ciclospori dose under C_2 monitoring according to the target peak concentration (500-600 μg/L) in most stable stage recipients following renal transplantation.