OBJECTIVE To investigate the feas-ibility of preserving parotid duct in regional excision of pleomorphic adenoma. METHODS 32 patients with parotid pleomorphic adenoma were treated by regional excision with the preservation of the parotid duct. RESULTS No relapse occurred during 3-6-year follow-up period. Transient facial nerve palsy occurred in only 3.1%(1/32) of patients and the drainage of the parotid duct on the surgical side was preserved. CONCLUSION Remaining function of the parotid gland function was preserved and the facial nerve was well-protected in the regional excision of pleomorphic adenomas, especially for patients with small pleomorphic adenomas.

Objective To discuss the therapeutic effect in the treatment of the acute limb arterial critical ischemia.Methods Collect thirty-nine cases of acute limb arterial critical ischemia in Renji Hospital from Janary 2014 to July 2016.According to the patients' manifestation,these operations were porfermed including thrombectomy,cathetery-directed thrombolysis,mechanical suction bolt,percutaneous angioplasty and stenting.The effect and complications were observed.Results The eighteen patients in 39 cases (46.2％) were dead,including 5 cases without operation,13 operation.The eight cases were amputated during 34 cases of operations.In the 21 out-patients safely,2 cases were not followed up.The time of follow-up was from 3 to 27 months,on average 14.3 months.During the 21 patients,5 cases died from heart cerebrovascular or tumor diseases,3 cases with footdrop,2 cases with toe amputations,3 cases with distal leg and foot anesthesias.Conclusions The patiens with acute limb arteries critical ischemia must be treated as early as,and reinforced the management of multiple organ function,which may improve the diseases' therapeutic effect.

Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases (48 ears) with chronic suppurative otitis media in the period of infection (31 with cholesteatoma, 17 with caries) were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete elimination of the lesions (typical or modified mastoidectomy). Results All eases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 eases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 eases, no change or worse in 3 eases. Conclusions Infection is not the absolute eontraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and eonchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main eanse to failure of surgery.

Objective To investigate the currents impact on delayed rectifier potassium (HERG)regulated by cyclooxygenase (COX)-2 in gastric cancer cells and its mechnism. Methods ① The HERG mRNA, protein and current in gastric cancer cells transfected with or without COX-2 antisense vector were measured by RT-PCR, Western blot and patch-clamp, respectively. ② cAMP concentration in gastric cancer cells transfected with or without COX-2 antisense vector was measured by ELISA. ③ The mutant HERG, which was absence of cAMP-binding domain, was constructed by PCR and transfected into gastric cancer cells. ④ The impact of COX-2 inhibitor and proglandin (PG) E2 on HERG current in gastric cancer cells transfected with or without mutant HERG was investigated by patch clamp. ⑤ The effects of agonist and antagonist of cAMP and inhibitor of protein kinase (PK) A on HERG current in gastric cancer cells transfected with or without HERG mutant were observed by patch clamp. Results ① The expression of HERG mRNA and protein in gastric cancer cells transfected with COX-2 antisense vector were not altered, but the amplitude of HERG current was diminished (P<0.05). ② The cAMP concentration in gastric cancer cells transfected with COX-2 antisense vector was lower than that in parental gastric cancer cells (P<0.05). ③ COX-2 inhibitor and PGE2 had influence on the HERG currents in gastric cancer cells. COX-2 inhibitor reduced and PGE2 enhanced the amplitude of HERG current in gastric cancer cells. However, neither COX-2 inhibitor nor PGE2 showed any negative or positive effects on currents of mutant HERG. ④ cAMP agonist enhanced the amplitude of HERG current and cAMP antagonist reduced the amplitude in gastric cancer cells. Neither agonist nor antagonist had effect on currents of mutant HERG. ⑤ PKA inhibitor did not influence the HERG current of parental gastric cancer cells and gastric cancer cells transfected with mutant. Conclusions COX-2 regulates HERG current through its catalytic product of PGE2, which binds with its receptor on the gastric cancer cells and alters cAMP level in gastric cancer cells, cAMP interacts with HERG protein by binding with cAMP-binding domain of HERG protein and exerts impact on HERG current. PKA does not participate in this process.

Objective To report the preliminary results of drug eluting stents (DES) in infrapopliteal bifurcation lesions after failed angioplasty.Methods From April 2011 to December 2013, 21 patients with critical limb ischemia and infrapopliteal atherosclerotic disease underwent DES placement in tibial bifurcation using 4 techniques: balloon and stent (single stent), T-shape double-stent, Crush double-stent and Culotte double-stent.Clinical and angiographic end points included: Amputation-free survival, target lesion revascularization (TLR)-free survival, target vessel revascularization (TVR)-free survival.Angiographic primary and secondary patency of DES, 2-vessel primary patency (2VPP), and 1-vessel primary patency (1VPP).Results Technical success was achieved in all patients (100％) without major intraoperative complications.ABI increased from 0.23 ± 0.07 to 0.67 ± 0.24 (P ＜ 0.05) after 1 week.The mean follow-up intervals were 23 ± 7 months;amputation-free survival, TLR-free survival and TVR-free survival were 100％, 90.5％ and 79.1％, respectively, at 1 year.8 patients underwent angiography reevaluation.The angiographic primary and secondary patency of DES were 62.5％, 87.5％, respectively.The primary patency of 2VVP and 1VVP were 28.6％, 57.1％, respectively at 1 year.Conclusions Bifurcation stenting techniques utilized in coronary arteries can be used in the infrapopliteal arteries.Although provisional stenting in the origin of tibial bifurcation cannot inhibit restenosis in distal lesions treated with balloon angioplasty, clinical outcomes and limb salvage rates are acceptable for these techniques.

Objective To study the proliferation inhibition effect by silencing PLCε gene expression with RNA interference in BIU-87 cells. Methods The specific short hairpin RNA recombinant plasmids were constructed by gene clone technology.The expression level of PLCε protein and mRNA were detected by Western blot and RT-PCR respectively after transfected recombinant plasmids into BIU-87 cells.The influence on proliferation was check by MTT.The changes of proliferating cell nuclear antigen(PCNA)were analyzed by immunocytochemical method,and the distribution of cell cycle was analyzed using flow cytometry. Results After transfected with the specific recombinant plasmids,PCNA expression was decreased 33.08%,and the analysis of cell cycle indicated that cells of G0/G1 phase were increased comparision with(40.75±2.30)%and(40.00±1.76)0A,and its G2/M phase cells(8.16±0.51)%were decreased strikingly compared with group control(31.20±1.76)%and group NP(35.94±1.58)%.Cells were blocked at G0/G1 phase,the cell proliferation was inhibited obviously. Conclusion PLCε may play an important role in proliferation of bladder cancer cells,which could be a potential target of biological treatment on bladder cancer in the future.

Objective To analyse the memory function and MRI changes in local-advanced nasopharyngeal carcinoma patients before-and after-radiation.Methods Clinical data,dosimetric data,digital span score and MRI of 14 cases with nasopharyngeal carcinom treated in Zhejiang Cancer Hospital from November 2015 to August 2016 were retrospectively analysed.There were 1 case at T2 stage,7 cases at T3 and 6 at T4.They received IMRT or TOMO therapy concurrent with 2 cycles Nedaplatin after 2-3 cycles PF/TP induction chemotherapy.Results The IMRT dosimetric data of 9 cases were available.For hippocampus and temporal lobe,the mean volume was (15.17 ± 2.17) and (95.07 ± 12.26) cm3,respectively,while the mean dose was (1 154.06 ±771.63) and (1 306.61 ±603.69) Gy,and the max dose (3 797.61 ± 1 450.98) and (5 394.17 ± 982.28) Gy,respectively.The equivalent uniform dose (EUD) was (2 233.28 ±872.73) Gy for hippocampus and (3 113.11 ±603.69) Gy for temporal lobe.10 patients received digit span score before-and 3 months after-radiotherapy.The mean score of forward digit span was 8.8 ± 1.8 before radiation and 8.1 ± 1.59 at 3 months after radiation(P ＞ 0.05),while thatof backward digit span decreased from 6.2 ± 1.04 before radiation to 5.3 ± 2.36 at 3 months after radiation (t =3.25,P ＜ 0.05).9 patients' MRI were available.Volume reduction of temporal lobe was observed (t =4.57,P ＜ 0.01) by voxel-based morphometry (VBM).Conclusions Radiation-induced injury to hippocampus and temporal lobe is inevitable in local-advanced nasopharyngeal carcinoma patients.There might be some connection between memory loss and temporal lobe volume atrophy after radiotherapy.Enrollment of larger sample analysis is expected.

Objective To explore the effect of nanow-band imaging (NBI) combined with magnifying endoscopy (ME) in early diagnosis of gastric cancer,and to observe whether it is helpful for inexperienced endoscopists to diagnose.Methods From April 2015 to October 2017,a total of 480 lesions were selected as research objects which were detected in the normal white light endoscopy (WLE).Pathological examination was used as the gold standard for diagnosis.3 experienced doctors were selected to read the endoscopy films.40 intern endoscopy doctors were selected to read the endoscopy filins at the same time after simple training.80 WLE images and narrowband imaging technology combined with magnifying endoscopy (ME-NBI) images were randomly selected to hold a film reading meeting.Real-time voting was used to judge the nature of lesions.Results The accuracy,sensitivity,specificity false positive rate and false negative rate of ME-NBI were 97.9％ (470/480),96.8％ (120/124),98.3％ (350/356),1.7％ (6/356),3.2％(4/124).And WLE values were 91.7％ (440/480),80.6％ (100/124),89.9％ (320/356),10.1％ (36/356),19.4％ (24/124),respectively.The diagnostic accuracy,sensitivity and specificity of ME-NBI were significantly higher than those of WLE (x2 =18.989,16.104,15.859,P≤0.05),and the false positive rate and false negative rate were significantly lower than those of WLE (x2 =22.772,16.104,P ≤ 0.05).The diagnostic results of ME-NBI of 40 endoscopy interns were significantly better than those of WLE (t =11.467,16.188,P ≤0.05).The diagnostic results of NBI by 40 interns were significantly better than that of WLE (t =11.467,16.188,P ≤ 0.05).Conclusions The accuracy of ME-NBI in screening early gastric cancer is satisfactory,and it has certain diagnostic value for inexperienced doctors.

Objective: To examine sleep characteristics of preschool children who were born preterm, which could provide a reference for the future intervention in the risk population. Methods: This retrospective cohort study was conducted from March 2017 to November 2018 in hospitals in cities of Guangzhou, Zhongshan, and Shenzhen, Guangdong Province, China, we recruited 202 preschool children aged 4-6 years, including 40 early-and moderate preterm (gestational age <34 weeks), 56 late preterm (34-36 weeks) , and 106 full-term preschool children (≥37 weeks). Caregivers reported children’s sleep time and habits using Chinese version of Children’s Sleep Habits Questionnaire (CSHQ). Results: Compared to the full-term group, the very-or-moderate-preterm group had shorter nighttime sleep duration (9.07±0.75 vs 9.33±0.59 h; adjusted β=-0.33), shorter total sleep duration (10.39±0.86 vs 11.05±1.32 h; adjusted β=-0.70), higher sleep duration score of CSHQ (4.60 ± 1.57 vs 3.97 ± 1.25 points; adjusted β=0.58), and higher sleepdisordered breathing score of CHSQ (3.78±1.27 vs 3.41±0.71 points; adjusted β=0.49). The late preterm group had lower parasomnias score of CSHQ (8.40±1.65 vs 8.75±1.72 points; adjusted β=-0.57), than the full-term group(P<0.05). When gestational age was analyzed as a continuous variable, it was positively associated with the total sleep duration (adjusted β= 0.06), while was inversely associated with sleep-disordered breathing scores of CSHQ (adjusted β=-0.06). Conclusion Very-or-moderate preterm children have shorter sleep duration and more sleep disordered breathing problems than full-term children, and have more disorders of sleeping duration and sleeping breathing than full-term children, while the late preterm children have less sleeping disorders than full-term children. The children of lower gestational age can have shorter sleep duration and more sleep-disordered breathing which should be addressed in future intervention.