Coblation is a new technology widely used in the otolaryngology in recent years.This article described the principle,indications,methods and advantages which the coblation was used in pharynx and throat diseases in children.It's a safe,effective and minimally invasive way.

Three hundred cases of E type viral hepatitis were observed with 100 cases of A type as control. We held that the etiology and pathogenesisof E and A types of viral hepatitis were wind, dampness, heat, poisons and stasis, each with its predominance; For A type, its predominant etiology being wind, heat and stasis, while that of E type, dampness, poisons and stasis. For their therapy, the principle of "similar treatment for different diseases " should, adopted. After treatment, ACT, TB, and a markedly decreased, signs and symptoms markedly improved, Epr, IgG also improved to different extents, the cured rate ( rate of negative virus exam) being 80% and 78% for A type and E type respectively. The effect was especially good for simple infection, and rather poor for mixed infection type.

As the patient of hepatitis B and E overlapping infection of liver and gallbladder damp - heat type compared with the patient of simple hepatitis E of liver and gallbladder damp-heat type, attack was very rapid, jaundice exacerbated progressively and hepatic function damaged severely. Aftertreatment the state of illness restored more slowly and the duration of illness was obviously prolonged. At the same time, it was found that the biochemical indexes (hyaluronic acid, total bile acid) increased significantly at acute stage, and the indexes in the patient of overlapping infection in the time for recovering normality at restoration stage was longer than that in the patient of simple hepatitis E, with a significantly difference between the two groups. It is indicated that lesion of the liver in the patient of overlapping infection of hepatitis B and E was more severe than the simple hepatitis E, with no good prognosis.

Objective To investigate cancer suppressor Genes p16, p15 in the brain gliomas expression and its relations with the gliomas pathology graduation and the malignant degree.Methods P16 and P15 protein expression level in human brain gliomas from 63 surgery specimens were assayed by immunobistochemical S-P method.Results P16, the P15 protein expression rate the brain gliomas pathology graduation assumes the inverse correlation with, also compared with the high malignant group the low malignant group (Ⅰ~Ⅱ level) (Ⅲ~Ⅳ level) has the remarkable difference (P

Objective To explore the expression of the Merlin protein in normal cervix and cervical can-cer of the Han,Tibetan and Hui nationalities in Qinghai. Methods Immunohisto-chemical staining was per-formed to detect the expression of Merlin in 108 cases of cervical carcinoma(40 cases of Han,38 cases of Tibetan and 30 cases of Hui nationality)and 107 cases of normal cervix(40 cases of Han,37 cases of Tibetan and 30 cas-es of Hui nationality). Results The positive expression rates of Merlin in normal cervix were 90.0%,91.9%and 86.7%respectively and those in cervical carcinoma were 17.5%,18.4%and 16.7%respectively. There was signifi-cantly statistical difference(P<0.05). However,there was no significant difference in the positive rates of Merlin between cervical carcinoma among different ethnic groups(P>0.05). The expression of Merlin was not correlated with age,FIGO stage,lymph metastasis and cell differentiation(P > 0.05)in cervical carcinoma of three ethnic groups. Conclusion The decrease or even deletion of Merlin may be involved in the development of cervical can-cer,and it plays an important role in cervical cancer. The expression of Merlin exerts no effect on the occurrence of cervical cancer and it is not associated with the clinical characteristics of the patients ,suggesting that it may not be involved in the invasion and metastasis of cervical cancer.

Objective To retrospectively analyze computerized tomography (CT) imaging features of colorectal cancer with chronic schistosomiasis in order to improve the diagnostic accuracy.Methods Eighty patients whose diagnosis was pathologically confirmed as colorectal cancer with schistosomiasis were collected from Tongji Hospital and Kunshan Chinese Medicine Hospital from January 2007 to December 2012.All the patients underwent abdominal plain CT and contrast-enhanced CT scan.The lesion location,morphology,size,calcification features,enhancement patterns and cancer metastasis were evaluated and compared by two radiologists who were blind to the diagnosis.Twenty colorectal cancer cases without schistosomiasis from the same area were also collected as controls.Results CT imaging showed that the tumors all occurred in the colon and rectum in 80 patients,mainly in colon descendens,colon sigmoideum and rectum.The lesion was characterized by irregular bowel wall thickening with soft tissue masses,and the average length of impaired intestine was (21.35 ± 4.50) cm.The lesions were solitary in 68 cases (85.0％) and were multifocal in 12 cases (15.0％).Linear,spotty and small patchy calcifications were seen in all the patients,with margins unclear in 59 patients (73.8％) and margins clear in 21 patients (26.2％).Early phase enhancement was seen in 68 cases (85.0％),of which 45 cases (56.2％) had homogenous enhancement and 23 cases (28.8％) had heterogeneous enhancement.Late phase enhancement was seen in 73 cases (91.2％) and necrosis was hardly seen.Only two cases (2.5％) had liver metastasis without lymphatic metastasis.All the 20 colorectal cancer cases without schistosomiasis presented with single lesion,which was characterized by irregular bowel wall thickening and local ulcer.The average length of impaired intestine was (6.90±3.40) cm.No calcification was seen in these lesions.All cases had early phase lesion with remarkable heterogeneous enhancement with low density necrotic area.The late phase enhancement was decreased.Four cases (20.0％) had liver metastasis.Compared to cases without schistosomiasis,cases with schistosomiasis tended to have multifocal (x2=100,P=0.000) and longer lesion (t=45.506,P=0.000),and more calcification (x2=100,P=0.000).The early phase heterogeneous enhancement was less frequent (x2 =88,P=0.000) and late phase enhancement was more frequent (x2=100,P=0.000).The liver metastasis rate was significantly lower (x2 =8.688,P =0.014).Conclusions The CT imaging of colorectal cancer with schistosomiasis is characterized by calcifications inside the tumor with obscured margins and multiple intestinal segments involvement.Hematogenous metastasis and lymphatic metastasis are rarely seen.

Objective To evaluate the correlation of ADC values on 3.0 T MR with the pathological grades in pT1b clear cell renal cell carcinoma(CCRCC).Methods Conventional MR images,ADC values and Fuhrman pathological grading of pT1b CCRCC were performed in 30 patients.Grade Ⅰ and Ⅱ were defined as low-grade group; grade Ⅲ and IV were defined as high-grade group.The differences of ADC values among four different pathologic grades were compared with a one-way analysis of variance. The comparison of ADC values of two different grade groups was performed with t test,and the ROC curve was performed to evaluate the diagnostic efficacy of ADC value. Correlation between pathological gradings and ADC values was assessed with Spearman rank correlation analysis. Results ( 1 ) The mean ADC value of grading Ⅰ ( 10 patients ), Ⅱ ( 8 patients ),Ⅲ ( 7 patients ),IV ( 5 patients ) was ( 0.94 ± 0.11 ) ×10-3 mm2/s,(0.82 ±0.13) × 10-3 mm2/s,(0.68 ±0.09) × 10-3 mm2/s,(0.59 ±0.03) × 10-3 mm2/s,respectively.Significant differences of ADC values among the four grades were present (F =16.422,P =0.000 ).( 2 ) The mean ADC value of the low-grade group was significantly higher than that of the high-grade group(t =5.738,P =0.000).Sensitivity and specificity of diagnosing the low-grade group was 88.9％ and 83.3％ respectively.There was a negative correlation between pathological grading and ADC value ( r =-0.807,P ＜ 0.05). Conclusions The ADC values of pT1b CCRCC have close correlation with pathological gradings.They can be used to predict the degree of tumor malignancy preoperatively and guide surgical planning.

Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.

Objective To analyze the clinical features in patients with primary cardiac tumors and surgical treatment of primary cardiac tumors.Methods A retrospective analysis of primary cardiac tumors patients from June 2002 to September 2012 was performed.79 patients were confirmed using cardiac echocardiography.Primary cardiac tumors were excised using general anesthesia during cardiopulmonary bypass.Results Only 5 patients relapsed after the follow-up for 6 months to 5 years.No tumor recurrence and distant metastases were found in the other patients.Conclusion Left atrial myxoma should be removed by surgical resection as soon as possible once there is a clear diagnosis.The surgical effect of left atrial myxoma is good but it may relapse.The malignant cardiac tumors progress rapidly and should be removed by early surgery combined with comprehensive treatment to improve the prognosis.

Objective To evaluate the expression of vascular endothelial growth factor (VEGF)and endostatin (ES) in the serum of patients with differentiated thyroid cancer at the time of before and after operation and postoperative recurrence. Methods The serum samples were obtained from 7 patients with postoperative lung metastasis and 21 patients with local recurrence after operation.The serum samples from 30 normal subjects were obtained as control.The levels of serum VEGF and serum endostatin were analyzed by enzyme-linked immunosorbentassay (ELISA).Thelevelsofserumthyroglobulinwereanalyzedby Chemiluminescence method.Statistical analysis was performed with t-test using SPSS 13.0 software.Pearson correlation analysis was performed for the correlation between serum VEGF and serum ES and thyroglobulin.ResultsThe levels of serum VEGF and serum ES in patients with lung metastasis 3 weeks after operation were significantly lower than those before operation and at the time of recurrence [ VEGF:( 210.3 ± 30.4) ng/L vs (412.6 ±57.3) ng/L and(619.5 ± 126.4) ng/L,P ＜0.05 ;ES:(25.2 ±6.2)ng/L vs (34.3 ±7.6)ng/L and (38.6 ± 8.7) ng/L,P ＜ 0.05 ].And the levels of serum VEGF and serum ES in patients with local regional recurrence 3 weeks after operation were significantly lower than those before operation and at the time of recurrence [ VEGF:(209.3 ±36.7) ng/L vs (399.4 ±56.3) ng/L and (406.5 ±59.2) ng/L,P ＜0.05;ES:(25.7 ± 4.7 ) ng/L vs ( 35.2 ± 6.8 ) ng/L and ( 31.2 ± 7.6 ) ng/L,P ＜ 0.05 ].The expression of serum VEGF and serum ES in patients with pulmonary metastasis were significantly higher than those in patients with local regional postoperative recurrence ( P ＜ 0.05 ).There was a linear positive correlation between serum VEGF,serum ES and thyroglobulin levels in the patient with recurrent differentiated thyroid cancer( r =0.752,0.349,P ＜0.01 ).Conclusion The serum VEGF and serum ES level were significantly elevated in patients with differentiated thyroid cancer before operation and recurrence.The serum VEGF and serum ES were importantindicators to reveal the biological behaviors of differentiated thyroid cancer.