Objective To explore and analyze the clinical characteristics and treatment strategy of severe complications caused by childrenˊs foreign bodies in esophagus.Methods The clinical data of 71 ca-ses of esophageal foreign bodies in children with ENT admitted to our hospital were analyzed retrospectively from Jan 2009 to Dec 2014.Results Esophageal foreign bodies in children with 71 cases,of whom 42 males and 29 females;aged from 2 months to 14 years old,highest incidence of 1 to 3 years old.Foreign bodies in esophagus lasted 2 h to 15 d.Ingestion of metallic foreign bodies in 43 cases,12 cases of plant-based foreign body,9 cases of animal foreign bodies,7 cases of chemical foreign bodies.Foreign bodies located in the upper esophageal was 51 cases,9 cases of the middle and 7 cases of the under section,3 cases of esophageal en-trance,1 case of falling into the stomach.In children with 71 cases,9 cases had complications,69 cases were cured,improved in two cases,and the cure rate was 97.2%,the average healing time was 4 d.Conclusion Early diagnosis and treatment,avoid esophageal perforation are the key to avoid the emergence of the compli-cations in children with esophageal foreign bodies,timely and accurate treatment of esophageal perforation and other complications are the effective measures to improve the cure rate.

Objective To detect the asymptomatic cardiovascular changes in children with adenoid hypertrophy.Methods One hundred and twenty children with adenoid hypertrophy underwent both chest X-ray and echocardiography before adenoidectomy,and echocardiography 6 months after operation.Results No child showed an increase in the cardiothoracic ratio on X-ray.But preoperative echocardiography showed an increase in pulmonary artery pressure [(22.6 ±3.6) mm Hg,1 mm Hg =0.133 kPa],a decrease in E/A (1.01 ± 0.17),and an increase in right ventricular end-diastolic diameters [(1.88 ± 0.18) cm].While after operation,pulmonary artery pressure decreased to(17.1 ± 3.2) mm Hg,E/A increased to 1.25 ± 0.12,and right ventricular end-diastolic diameters decreased to (1.67 ± 0.11) cm.Each index change before and after operation was statistically significant(P ＜ 0.05).Conclusion Adenoid hypertrophy can result in clinically asymptomatic cardiopulmonary changes.Early diagnosis and treatment of this disease can prevent serious cardiopulmonary complications.

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

Objective To investigate the effectiveness and safety of endovascular embolization for the treatment of middle cerebral artery aneurysms. Methods From March 2007 to May 2015,the clinical data of 170 patients with 173 middle cerebral artery aneurysms treated with endovascular embolization at the Department of Neurosurgery,Nanjing Jinling Hospital were analyzed retrospectively,including 120 (69.4%)ruptured aneurysms and 53 (30. 6%)unruptured aneurysms. The incidence of complications and prognosis were compared between the 2 groups. Results (1)A total of 170 patients who could perform endovascular embolization after preoperative evaluation successfully completed the interventional procedure. None of the patients died. (2)18 patients (10. 6%)had intraoperative and postoperative complications,including 4 (7. 5%,4/53)in the unruptured aneurysm group and 14 (11. 7%,14/120)in the ruptured aneurysm group. There was no significant difference in the incidence of complications between the two groups. (3)101 patients were followed up for 3-48 months. No new nervous system symptoms and reruptured aneurysm were observed. One patient had recurrence in the unruptured aneurysm group and 4 had recurrence in the ruptured aneurysm group. Conclusion Endovascular treatment of middle cerebral artery aneurysms is a safe,effective,and feasible technique.

Objective Toinvestigatetheapplicativevalueof3D-DSAandheadMRIorCTfusion technology for guiding the individualized treatment of intracranial arteriovenous malformation (AVM ). Methods Twenty-onepatientswithAVMdiagnosedwithDSAattheDepartmentofNeurosurgery,Nanjing General Hospital of Nanjing Military Command from January 2015 to May 2015 were analyzed retrospectively. All patients performed DSA,MRI,and CT scan respectively before procedure,and they also performed 3 D-DSA and MRI or CT fusion. Of the 21 patients,15 performed MRI and 3D-DSA fusion,6 performed CT and 3D-DSA fusion. According to the image fusion results of the patients,the individualized treatment regimens were further developed,including microsurgical resection,endovascular embolization,and stereotactic radiotherapy (alone or combined treatment). The patients were followed up and observed for 2 to 6 months after procedure.Results Fromthe3D-DSAwithheadMRIorCTfusionimagesofthepatientsbeforetheprocedure not only could observe the vascular architecture of AVM,the relationship between the niduses and the surrounding nerve structures,but also could precisely locate the positions of AVM with small aneurysms or tiny AVMs. According to the results of image fusion,17 patients with AVM were treated with microsurgical resection,2 were treated with interventional embolization and stereotactic radiotherapy,and 2 were treated with stereotactic radiotherapy only. Of the 17 patients with AVM underwent microsurgical resection, none experienced intracranial rebleeding during the follow-up period. The last Glasgow outcome scale (GOS)score was 5 in 13 cases,and 4 in 4 cases. One patient with AVM underwent combined stereotactic radiotherapy had intracranial rebleeding during the follow-up period,and their last GOS score was 4. The other remaining 3 patients did not have new neurological deficits or rebleeding during the follow-up period,and theirGOSscorewas5.Conclusions 3D-DSA,headMRI,andCTfusiontechnologyarenovel, the operative method is simple,and the fusion image is accurate. They can effectively develop the individualized treatment regimens for patients with AVM.

Objective This study was focused on the association between neutrophil extracellular traps (NETs) and interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Thirty six patients who satisfied the Bohan & Peter criteria for DM were recruited to this study,among whom 19 were complicated with ILD.Forty seven age and sex matched healthy Chinese volunteers were selected to be control subjects.The plasma samples of these patients were tested for the formation and degradation of NETs.Results DM plasma induced more NETs formation than control plasma did [(246±93) RFUs vs (192±53) RFUs,P=0.002].Compared to control,DM plasma exhibited a signficantry decreased ability to degrade NETs.Further mere,compared with DM patients without ILD (DMNL),DM patients with ILD (DML) could not degrade NETs completely [(83±13)％ vs (59±21)％,P＜0.01].All four DM patients with subacute ILD exhibited a significantly lower ability to degrade NETs than patients with chronic or asymptomatic ILD [(36±14)％ vs (65±19)％,P=0.0139].Conclusion These data show that more NETs formation is induced by plasma and DML fails to completely degrade NETs.These suggest that NETs may play a role in the pathogenesis of DM and DM-associated ILD.

Adenocarcinoma ; metabolism ; pathology ; surgery ; ultrastructure ; Aged ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; surgery ; ultrastructure ; Cardia ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Microscopy, Electron, Transmission ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Synaptophysin ; metabolism

Objective To investigate the effect of parent artery occlusion with liquid embolic agents (Onyx)for the treatment of distal intracranial aneurysms. Methods The clinical data of 27 patients with 29 ruptured distal intracranial aneurysms were analyzed retrospectively.Seventeen aneurysms located in the posterior inferior cerebellar artery,3 in the anterior inferior cerebellar artery,2 in the superior cerebellar artery,2 in the posterior cerebral artery,1 in the anterior cerebral artery,and 4 in the middle cerebral artery.Twenty-eight aneurysms were treated with Onyx to occlude proximal parent arteries and aneurysms, and 1 distal middle cerebral artery aneurysm was occluded spontaneously. Results All the aneurysms treated were occluded completely.One patient died of intraoperative hemorrhage.The remaining patients were followed up for 8 to 67 months.The final Glasgow outcome scale (GOS)scores were 5 in 23 patients and 4 in 3 patients. 17 patients were followed up with digital subtraction angiography (DSA)and 5 were followed up with computed tomography angiography (CTA)after procedure.There was no recurrence of the aneurysm. Four patients were followed up clinically.No new neurological disturbance or rebleeding was found in all the survived patients. Conclusion Medium-long term follow-up results have shown that the clinical efficacy of proximal parent artery occlusion with Onyx for the treatment of distal intracranial aneurysms is satisfactory,and the recurrence rate is low.

Objective To compare the difference of the left ventricular structure and diastolic func-tion in normotensive offspring with or without a family history of hypertension. Methods One hundred nor-motensive offspring were assessed. Fifty had a family history of hypertension (experimental group) and 50 had no family hi.history of hypertension (control group). By eehocardiography and Doppler tissue imaging, the following parameters of left ventricular structure and diastolic function were examined: interventricular septal thickness (IVST), left ventrieular posterior wall thickness (LVPWT), left ventricular internal dimension (LVIDed), left ventrieular mass index(LVMI) and E/A. Results Compared with control group, experimen-tal group had higher IVST, LVPWT and LVMI, lower peak velocity of the early diastolic wave (e) of mitral annulus, and lower e/a (P<0.05). No differences in LVIDed, left atrial diameter (LA),aortic dimension(AOD), E,A and E/A were found between the two groups. Conclusion The results indicate that genetic factor of parental hypertension influence left ventrieular structure and diastolic function in normotensive offspring, which may precede the elevation of blood pressure.