[ABSTRACT]OBJECTIVETo investigate malignant transformation of sinonasal inverted papilloma(SNIP) treated by endoscopic or endoscope assisted surgery, in order to analyze its probable prognostic factors and the optimized method.METHODSThe clinical data of 27 cases with malignant transformation of SNIP treated by endoscopic or endoscope assisted surgery from September 2001 to September 2010 were reviewed. According to preoperative imaging examination and UICC staging criteria, 3 cases were T1, 8 cases were T2, 12 cases were T3 and 4 cases were T4. 16 of them received radiotherapy after endoscopic surgery while the other 11 received surgery alone. RESULTSAll cases were confirmed as squamous cell carcinoma pathologically after surgery. The 5-year overall survival rate was 77.8% for all the patients. The 5-year survival rate was 75.0% for surgery alone group, of which 5 cases recurred locally after operation. The 5-year survival rate was 81.8% for surgery combined with radiotherapy group, of which 5 cases recurred locally and 2 cases died from intracranial metastasis.CONCLUSIONEndoscopic or endoscope assisted surgery can be used in the management of malignant transformation of SNIP to improve the quality of life, with the preponderances of desired effect and less complication. Application of radiotherapy after surgery could improve long-term survival rate of the patients.

We present a rare case report of foreign body of the nasal apex in a 22-year man who were hospitalized because of a bit of metal rebounded. There was slight bleeding at wound site with a feeling of pain and swelling. On physical examination, the apex lied in the median position with a bleeding cut about 3 millimeter in length. There was no visible stump on the cut or rupture in the nasal vestibular. Computed tomographic scan showed the abnormal high-density shadow in the nasal apex while the foreign body was located in the subcutaneous tissue of the antero-upper part of septal cartilage. The admitting diagnosis was foreign body in nasal apex. Endoscopic surgery was adopted to remove the foreign body.
Endoscopy ; Foreign Bodies ; surgery ; Humans ; Male ; Metals ; Nasal Cartilages ; pathology ; Nasal Cavity ; surgery ; Pain ; Subcutaneous Tissue ; pathology ; Young Adult

OBJECTIVE: To summarize the clinical characteristics and treatments of patients with malignant transformation of sinonasal inverted papilloma (SNIP), and to explore the factors influencing the prognosis of malignant SNIP. METHOD: To retrospectively analyze the clinical data of 35 patients with malignant SNIP. The prognosis affected by age, gender, pathogenetic locations, pathology, clinical stages and treatments were analysed using Kaplan Meier, Log rank and Cox method. RESULT: In our research, 5 years survival rate was 68.6% in malignant SNIP. There were 3 factors effecting the 5 years survival rate of malignant SNIP: clinical staging, histopathological features and treatments while gender, age, disease location, and percentage of the malignant cell in the entire tumor tissue had no effect on overall survival rate. Clinical staging and treatment were the independent factors that influenced the prognosis of malignant SNIP (P value was 0.019 and 0.006). CONCLUSION Risk factors that independently influence the survival of patients with malignant SNIP were the clinical staging and treatment. The degree of histo pathological features can be the secondary indicator to judge the prognosis of malignant SNIP. Endoscopic surgery or comprehensive therapy performed on patients properly is therapeutically effective.
Cell Transformation, Neoplastic ; Endoscopy ; Humans ; Nose Neoplasms ; diagnosis ; pathology ; Papilloma, Inverted ; diagnosis ; pathology ; Prognosis ; Retrospective Studies ; Survival Rate

Background:Irritable bowel syndrome( IBS ) is one of the most common functional gastrointestinal disorders. Analyzing the regional differences of symptomatic profiles may provide guidance for the diagnosis and treatment of IBS. Aims:To preliminarily investigate the symptomatic characteristics of IBS patients in Fujian province,China for the reference of diagnosis and treatment of the disease. Methods:A total of 703 IBS out-patients based on the RomeⅢcriteria and presented to the gastroenterological clinic of 15 tertiary hospitals in Fujian Province,China from Jun. 2011 to Apr. 2012 were enrolled in a face-to-face survey. The questionnaire mainly included demographic data,course of the disease, and clinical symptoms. Results:In 703 IBS patients,the ratio of male to female was 1:1. 3,and the peak of age was 35-45 years(32. 4%). More than half of the patients were diarrhea-predominant IBS(IBS-D,58. 2%),while constipation-predominant IBS( IBS-C)accounted for 22. 6% of the patients. Abdominal pain/discomfort,abdominal distention and abnormal defecation,including diarrhea,constipation,feeling of incomplete defecation and mucous stool were the most important lower GI symptoms. In the four subtypes of IBS,the symptoms of mixed IBS( IBS-M)were most serious( P<0. 05). Compared with IBS-C,abdominal pain was more severe in IBS-D and IBS-M(P<0. 05),however,abdominal distention was more severe in IBS-C than in IBS-D(P<0. 05). About one third of the patients(32. 9%)were overlapped with upper GI symptoms,and the most common upper GI symptoms were postprandial fullness and eructation. Sixty-eight (9. 7%)patients were overlapped with functional dyspepsia. Conclusions:In Fujian Province,China,more than half of the IBS patients were IBS-D. The symptomatic profiles are different between different subtypes of IBS. Some of the IBS patients may be overlapped with upper GI symptoms or functional dyspepsia.

As the main part of the teaching activities,students play an important role in the teaching reform.The students were trained through 3 pathways,“Extending teaching activities from the classroom to the outside”,“Development from basic to clinical knoledge” and “Culturing students' innovative consciousness”,so as to allow them to give full play in teaching reform,to enhance their ability of practice and learning by themselves,to culture their innovative consciousness and to develop students' leading functions in the anatomy teaching reform.

Objective To analyze the prognostic factors in patients with cervical squamous cell carcinoma of stage Ⅰb and Ⅱa treated by surgery,and to investigate their guid roles in available post-operation adjuvant therapy. Methods The clinicopathologic records of 306 patients with cervical squamous cell carcinoma of stage Ⅰb and Ⅱa who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively analyzed, and the prognostic factors were explored by univariate and multivariate methods. Independent prognostic factors were identified by COX proportional hazards regression model. Results The overall 5-year survival rate of these 306 patients was 78.1%. In univariate survival analysis, the poor prognostic factors included poor differentiation, positive pelvic lymph nodes, deep stromal invasion, parametrial extension, tumor size≥4 cm, and lymph vascular space involvement (P

0.05).ConclusionThe neoadjuvant radiochemotherapy can improve the sphincter-saving rate,probably can improve the resection rate and reduce the recurrence rate for the middle-lower rectal carcinoma.

OBJECTIVETo observe the effect of Chinese herbal extract HuNan A-1 (HNA-1) on the thymic output function in Simian immunodeficiency virus (SIV) chronically infected rhesus macaques.

METHODSEight Chinese rhesus macaques had been infected by SIVmac239 for 16 to 21 months, and then they were randomly divided into the treatment group and the control group, 4 in each group. Monkeys in the treatment group were administered with HNA-1 by gastrogavage, once daily for 2 successive months, while those in the control group were administered with equal volume of normal saline by gastrogavage, once daily for 2 successive months. The general condition and body weight of monkeys were observed. Plasma viral loads were detected using real-time fluorescent quantitative PCR assay. CD4 percentages and counts, as well as naive CD subsets were detected using flow cytometry. T-cell receptor excision circles (TREC) were detected using real-time fluorescent quantitative PCR assay. The thymus tissue was pathologically observed using routine HE staining. The correlation between lesions of the thymus tissue, CD4 counts, naive CD counts, and TREC were analyzed.

RESULTSThere was no statistical difference in body weight, viral loads, absolute CD ratios between the two groups after treatment (P > 0.05). The altered TREC multiple showed an obvious decreasing tendency in the control group, while it showed an increasing tendency in the treatment group (P < 0.05). In both groups, destroyed structures of the thymus tissue could be seen, filled with pink unstructured material. Increased connective tissues, lowered connective cell density, and confused arrangement could also be seen in the two groups, with no obvious difference. TREC contents were positively correlated with naive CD4 counts after removing extremum (r = 0.926, P = 0.001). Naive CD4 counts were positively correlated with CD4 counts (r = 0.961, P = 0.005).

CONCLUSIONSTREC content determination, as a marker of newly thymic emigrants, could be taken as a testing method for evaluating the thymic output function. Besides, HNA-1 treatment increased the thymic output significantly in SIV chronically infected monkeys. Correlation existed among TREC contents, naive CD4 counts, and pathologies of thymus tissues, especially in late infection stage.

Animals ; CD4 Lymphocyte Count ; Drugs, Chinese Herbal ; pharmacology ; Flow Cytometry ; Macaca mulatta ; Plant Extracts ; pharmacology ; Random Allocation ; Simian Acquired Immunodeficiency Syndrome ; drug therapy ; Simian Immunodeficiency Virus ; Thymus Gland ; drug effects ; Viral Load

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

This study was aimed to observe effect of pomegranate leaf tannin and ellagic acid on primary rat adipocyte differentiation and lipid metabolism-related factor expression. Primary rat preadipocyte was in vitro cultured to observe the effect of pomegranate leaf tannin and ellagic acid on lipid fat cells as well as mRNA expression of its related factor. The results showed that pomegranate leaf tannin and ellagic acid had obvious inhibition effect on fat formation in fat cells. It had certain inhibition effect on activities of lipoprotein lipase (LPL) and glucose-3-phosphate dehydrogenase (GPDH). It promoted fat decomposition and reduced intracellular lipid content. It upregulated PPARγ and fatty acid-binding protein (aP2). It downregulated obese (ob) gene level. It was concluded that pomegranate leaf tannin can inhibit fat generation of fat cells and promote fat metabolism. Ellagic acid was its main active ingredient, which had the same effect as pomegranate leaf tannin.