The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.
Adenoma, Pleomorphic ; pathology ; surgery ; Adult ; Catheter Ablation ; Endoscopy ; Epistaxis ; Female ; Humans ; Nasal Cavity ; pathology ; Nasopharyngeal Neoplasms ; pathology ; surgery

Objective To investigate the epidemiological features of respiratory syncytial virus (RSV) A and B in hospitalized children with acute respiratory tract infections(ARTIs) and to analyze the genetic characteristics of G protein gene of RSV in Chongqing area, especially for BA strains. Methods Nasopharyngeal secretions collected from 508 hospitalized children with ARTls from April, 2008 to March, 2009 were screened for RSV using RT-PCR. Full length G protein gene was amplified by RT-PCR from 10 RSV subtype A and 29 RSV subtype B strains. Results Out of the total 508 specimens, 126 (24.8%) were revealed positive for RSV. RSV subtype A and B viruses accounted for 34.1% and 63.5% of the total positive specimens, respectively. The remaining 2.4% of the specimens were positive for both subtype A and B. At the nucleotide level, identities between the 10 subtype A virus G genes and that of the prototype strain A2 were 91.4% -92.0%, indicating genotype GA2. Identities of the 29 subtype B virus G genes and that of the CH18537 strain were 92.0%-93.0%. Nineteen out of 29 RSV subtype B isolates contained highly repeated 60 nucleotides insertion in G protein gene, namely BA strain. As compared to the prototypes, the RSV G protein gene included nucleotide deletion, insertion, substitutions, especially in the carboxy-terminal third of the G gene. Condnsion RSV has been the major cause of acute respiratory tract infections in children in Chongqing area. Subtype B strains, especially BA strains, were predominant during the study peried. Whether the predominated circulation of BA strain is resulted from enhanced attachment function of G protein remains unknown.

Two cases of atrophic dermatofibrosarcoma protuberans (DFSP) are reported.The patients were a 16-year-old and a 24-year-old boy with a clinical course of 6 and 5 years respectively.The lesions began as well-marginated atrophic erythema,and subcutaneous nodules appeared gradually on the erythema.Histopathology showed atrophic or normal epidermis,wavy arrangement of tumor (spindle) cells in the superficial dermis which was aligned parallel to the epidermis,storiform arrangement of tumor cells in the lower dennis,and typical lacelike pattern of infiltration of subcutaneous fat tissue with tumor cells.Immunohistochemistry showed that the tumor cells stained positive for vimentin and CD34,but negative for S100 or CD 68.

Objective To analyze the gene expression of pathogenic factors in vaginal secretions of patients with vulvovaginal candidiasis by using Oligo chips. Methods RNA was extracted from vaginal secretions of 10 patients with vulvovaginal candidiasis and 3 asymptomatic carriers, and hybridized with oligonuscreened followed by a bioinformatic analysis. Results Comparing with the asymptomatic carriers, the patients showed a higher expression of 44 genes and lower expression of 17 genes. Of these differentially expressed (TLR) 4, HWP1, SAP2, SAP5, LIP4, EFG1 and CPH1 were highly expressed in more than 80% of the secretion samples from patients with an average ratio of 4.013, while LIP6 and WH11 were lowly expressed in more IFN-γ and TLR4 were associated with native immunity, HWP1 associated with hyphal adhesion and formation, SAP2, SAP5, LIP4 and LIP6 associated with extracellular hydrolysis, and EFG1, CPH1 and WH11 associated with phenotypic switching. Conclusions Both the host adaptive immunity deficiency and increased virulence of Candida species are involved in the pathogenesis of vulvovaginal candidiasis, and TLR4 possibly plays a certain role in the local immunity of patients with this entity.

Objective To determine the extracellular enzymatic activity of common pathogens for onychomycosis, in the hope of finding virulence factors associated with the pathogenesis of onychomycosis. Methods Strains tested in this study included standard strains of common dermatophyte and non-dermatophyte fungi as well as clinical isolates of Trichophyton rubrum from patients with onychomycosis. All the tested strains were cultured in medium containing nail fragments at 25 ℃ for 10 to 21 days followed by the determination of the nail fragment-containing medium, a significant increase was observed in the activities of esterase, esterase lipase, N-acetyl-β-glucosaminidase and α-mannosidase in dermatophytes compared with non-dermatophytes (all P ＜ 0.05 ), as well as in the activity of N-acetyl-β-glucosaminidase in Trichophyton rubrum compared with the other tested species of fungi (all P ＜ 0.05). No significant difference was noted in the activity of extracellular enzymes, except for that of naphthol-AS-BI-phosphohydrolase, between the isolates of Trichophyton rubrum from patients with different ranges of scoring clinical index for onychomycosis (SCIO). Conclusions In specific conditions, the extracellular enzymatic activity of fungi isolated from patients with onychomycosis is associated with fungal species, and may have a certain influence on the manifestations of anychomycosis.

Objective: To explore the effect of single-nostril transsphenoidal approach on pituitary adenoma. Methods: We retrospectively analyzed 46 cases of pituitary tumors treated with single-nostril transsphenoidal approach and the effects and complications of surgery.Dunng the surgery,a nasal speculum was inserted through right nostril slowly towards the anterior wall of sphenoid sinus.A nasal mucosa incision of about 1.5cm was made in the right nasal cavity at the level of the middle nasal turbinate.With a fracture of the bony septum,a space was developed between the bilateral nasal mucosa and bony septum to the sphenoid sinus.Then,the face of the sphenoid sinus was exposed.The remainder of the bony septum,the anterior sphenoid sinus wall,and the sphenoid mucosa were removed.The antenor sphenoidotomy should be less than 1.5cm wide.After confirming the tumor by dural puncture,a cross incision of dura was made and the tumor was removed.The saddle was usually Collapsed and visible after total tumor removal.When the tumor was resected,sevaral gelatin sponges were stuffed into the Surgical cavity to stop bleeding. Results: Thirty-four cases had total resection and 12 cases had subtotal resection.No deaths or disability occurred.Hormone levels in almost all patients were improved.Seventeen cases had a sign of diabetes insipidus.Electrolyte disturbance occuwed in 5 cases.NO postoperative cerebrospinal fluid rhinorrhea was observed. Conclusion: Single-nostril transsphenoidal approach has many advantages in treating pituitary adenomas such as simplified approach,brief technology and high security.

Objective To evaluate the performance of anti-type Ⅶ collagen antibody detection using enzyme-linked immunosorbent assay (ELISA) in the auxiliary diagnosis of a case of epidermolysis bullosa acquisita (EBA),and to analyze its sensitivity and specificity for the diagnosis of EBA in large-scale studies by review of relevant literature.Methods Serum samples were collected from a patient with typical clinical,histological and immunological manifestations of EBA,4 healthy human controls,5 patients with bullous pemphigoid and 3 patients with pemphigus vulgaris.ELISA was performed to determine the serum levels of anti-type Ⅶ collagen antibodies.Literature regarding the diagnosis of EBA using ELISA was reviewed with a summary of inclusion criteria for patient enrollment,coating antigens,sensitivity and specificity.A comparison was carried out between ELISA and the other serological methods.Results Anti-type Ⅶ collagen antibodies were detected by ELISA in the serum of the patient with EBA (136 U/ml),but not in the other serum samples.The sensitivity and specificity of ELISA in the diagnosis of EBA differed in different studies,but in general,the accuracy of ELISA was higher than that of immunoblotting.Conclusion ELISA is a simple and convenient tool for the diagnosis of EBA with high accuracy.

Objective To evaluate the effects of edaravone postconditioning and remote ischemic postconditioning on myocardial ischemia/reperfusion (I/R) injury in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each):sham operation group (group S); group I/R; edaravone postconditioning group (group E); remote ischemic postconditioning group (group P); edaravone postconditioning and remote ischemic postconditioning group (group EP).Myocardial I/R was induced by occlusion of anterior desending branch of left coronary artery for 30 min followed by 180 min reperfusion.Edaravone 3 mg/kg was injected intravenously at 1 min before reperfusion in groups E and EP.The animals underwent 10 min ischemia of bilateral hind limbs starting from 20 min of myocardial ischemia in groups P and EP.Left ventricular systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP) and ± dp/dtmax were measured and recorded during reperfusion.Results Compared with group S,LVSP and ± dp/dtmax were significantly decreased and LVEDP was increased in the other groups (P ＜ 0.05).LVSP and ± dp/dtmax were significantly higher and LVEDP was lower during reperfusion in groups E,P and EP than in group I/R,and in group EP than in groups E and P (P ＜ 0.05).Conclusion Edaravone postconditioning and remote ischemic postconditioning can alleviate myocardial I/R injury and offers better efficacy than either alone.

Objective To investigate the clinical effect of laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors.Methods Retrospectively review the clinical data of 35 patients suffering multiple segmental intraspinal tumors,who underwent the laminoplasty with bone grafting for intraspinal tumor resection in Department of Neurosurgery,Clinical Medical College of Yangzhou University,from June 2013 to May 2016.Observation indicators:(1) surgical and postoperative recovery situations,including tumor resection,number of lamina reset,tumor pathological results,clinical efficacy evaluation,complications,etc;(2) follow-up situations,including spinal stability evaluation,rate of bone graft fusion,tumor recurrence.Follow-up using outpatient examination and telephone interview was performed by the end of December 2017.Results (1) Surgical and postoperative recovery situations:of the 35 patients,31 achieved total tumor resection,3 subtotal tumor resection and 1 partial tumor resection.There were no spinal dura mater injuries when laminectomy was performed,and 84 laminae were repositioned and implanted.The neurological function of the spinal cord was evaluated based on McCormick scoring system:32 cases were improved and 3 cases were controlled.Incision healing was bad in 2 patients,and cerebrospinal fluid leakage occurred in 1 case,which all recovered after treatment.(2) Follow-up situations:all the 35 patients were followed up for 8 to 36 months,with a median time of 14.2 months.Imaging examination more than 6 months after operation:no spinal instability was found in standing spine X-ray examination;CT scan showed a total of 142 sides in the 84 vertebral plates (168 sides) had achieved bone fusion,the fusion rate was 84.5％,and no titanium nail removal and connecting piece shift was found;MRI showed no tumor recurrence in all patients.Conclusion Use of the laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors can achieve good clinical efficacy,high fusion rate for resected laminae and satisfactory spinal stability.

Objective To observe the dopamine(DA)concentrations in the lateral geniculate nucleus in guinea pigs with flickering light-induced and form deprivation myopia,and to compare and analyze the pathogenetic mechanisms in the centers of vision of these two different myopia models. Methods Twenty-four two-week-old guinea pigs were randomly assigned to three groups(n=8):flickering light-induced myopia(FLM)group, form deprivation myopia(FDM)group and control group. All the groups were fed for 8 weeks. The refraction and axial length(AL)were measured before and af-ter modeling. After eight-week modeling,the contents of dopamine in the left lateral geniculate nucleus were detected by high performance liquid chromatography with electrochemical detection(HPLC-ECD). Results Before modeling,no sig-nificant difference was found in refraction and AL among the three groups. After eight-week modeling,in contrast with the control group,significant differences were found in changes of both refraction(P<0.001)and AL(P<0.05)in the right eyes of FLM and FDM groups,indicating that the two myopic models were successfully established. The result of HPLC-ECD showed that the contents of DA in the left lateral geniculate nucleus in FLM group were significantly higher than the control group(P=0.01),while in the FDM group it was lower than the control group(P=0.021). The average contents of DA were as follows:(37.04 ± 1.18)pg/μL in the control group;(24.27 ± 3.46)pg/μL in the FDM group; and (45.58 ± 1.98)pg/μL in the FLM group. Conclusions The content of DA in the lateral geniculate nucleus is increased in FLM,while decreased in FDM,indicating that the expression of DA in LGN and the mechanisms of formation of these two experimental myopia are different.