[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.

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

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.

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 determine the frequency of polymorphism at exon 26 (C3435T) of muhidrug resistance 1 gene (MDR1) in epileptic patients in the southern Chinese and to study the association of this polymorphism with pharmacoresistance.Methods DNA samples were obtained from 134 patients,of whom 72 were resistant to antiepileptic drug treatment and 62 were responsive to the treatment. Genotypes of the C3435T polymorphism were determined by polymerase chain reaction (PCR) followed by restriction digestion and gel electrophoresis.Genotype and allele frequencies in the drug resistant group were compared to those in the response group by Chi-square analysis.Results Of all 134 patients,33 (24.6%) had CC genotype,72 (53.7%) had CT genotype,and 29 (21.6%) had TT genotype.The frequency of CC genotype was significantly higher in the pharmaeoresistance group (33.3%) than that in the responsive group (14.5%,P=0.012).The frequency of the C allele was also significantly higher in the pharmacoresistance group (57.6%) than that in the responsive group (44.4%,P=0.03).When patients were divided by types of seizure into three groups:generalized seizure group,partial seizure group,and undefined seizure group,the CC genotype and C allele were associated with pharmacoresistance in the partial seizure group.Conclusions In the southern Chinese,the CC genotype and C allele are associated with resistance to the antiepileptic treatment.This finding needs to be verified in studies with larger sample size.

Objective To explore the correlation between hyperlipidemia and colorectal polyps by compare the level of serum lipids in patients with colorectal polyps.Methods The levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) of 159 patients with colorectal polyps and 138 controls were tested.The serum lipids between colorectal polyps group and control group,of colorectal polyps with different pathological type,of adenomatous polyps with different pathological type,of adenomatous polyps with different location,colorectal polyps of different gender were compared.Chi square test or t test were performed for data analysis.Results The incidence of hyperlipidemia of colorectal polyps group was 41.5％ (66/159),which was higher than that of control group (16.7％,23/138) and the difference was statistically significant (x2 =36.56,P＜0.01),its levels of TG,TC and LDL-C were all higher than those of the latter ((1.52±0.56) mmol/L vs (1.06 ± 0.42) mmol/L,(5.22±0.86) mmol/L vs (4.52±0.96) mmol/L,(2.85±0.66) mmol/L vs (2.52± 0.35) mmol/L; t=4.23,4.02,3.72,all P＜0.01).There were no significant differences in the levels of TC,TG and LDL-C between colorectal polyps with different pathological type (all P＞ 0.05).The incidence of hyperlipidemia of tubular villous adenoma and villous adenoma (progressive adenomas) was 60.0％ (15/25),which was higher than that of tubular adenoma group (33.3％,20/60) and the difference was statistically significant (x2=5.18,P＜0.05).The incidence of hyperlipidemia of left colon and rectal polyps group was 46.2％ (49/106),which was higher than that of right colon polyps group (28.6 ％,12/42) and the difference was statistically significant (x2 =3.87,P＜0.05).The incidence of hyperlipidemia of male colorectal polyps group was 47.2％ (51/108),which was higher than that of female group (29.4％,15/51) and the difference was statistically significant (x2 =4.53,P＜0.05).The level of TG of male colorectal polyps group was higher than that of female group ((1.84 ± 0.73) mmol/L vs (1.55±0.65) mmol/L) and the difference was statistically significant (t=3.98,P＜0.05).Age (r=0.766,P=0.009),TG level (r=0.535,P=0.012) and TClevel (r=0.688,P=0.025) were positively correlated with genesis of colorectal polyps.Conclusion There is a significant correlation between hypertriglyceride,hypercholesteremia and colorectal polyps.