Objective To design a new type of nasopharyngeal airway tube,which can resolve the upper respiratory tract obstruction due to general anesthesia.Methods All types of used flex endotracheal tube were collected.Take off the cuff outside of the tube wall and cut them into different lengths.Then,the connectors were reinstalled to the prepared tubes.Results With the designed nsopharyngeal airway tubes inserted,50 patients having complicated glossocoma in general anesthesia no longer snored and they could breathe freely.Conclusion The new type of nsopharyngeal airway tube is easy to produce and adapts well to clinical work.

Objective To explore the expression of miR-9 in H/RS cells and its regulation on target PRDM1.Methods miR-9 expression in normal CD19+ B-cell subsets and eight lymphoma cell lines was detected by fluorescence quantitative RT-PCR and in situ hybridization (ISH),for quantification and location,respectively.Chemically synthesizcd antisense oligonucleotide of miR-9 was transiently transfected into L428 for its silence,and the PRDM1 expression was tested.Results Fluorescence quantitative RT-PCR showed that the expression of miR-9 in L428 cells was marked higher than that of normal CD19+ B-cell subsets and other lymphoma cell lines (the expression of miR-9 in L428 cells was 47-fold of OCI-Ly1,50-fold of Raji cells,7-fold of EBV+ immortalized B cell line,and 6-fold of ALCL cell line).ISH indicated that miR-9 located in cytoplasm,it was a diffuse and strong positive in L428,scattered and weak in DLBCL and Burkitt' s lymphoma cell lines,while negative in KARPAS-299 or Jurkat cell lines.Transient down-regulation of miR-9 in L428 leded to the increase of PRDMI protein.Conclusion miR-9 plays the role of cancer gene in cHL,and may exert a potential function in regulating terminal B cell differentiation through a post transcription regulation of PRDM1 gene.

Objective The clinical effects of endoprotheses in the palliative treatment of malignant biliary obstruction were evaluated.Methods The palliative treatment of endoprothese in 74 cases(including 42 Wallstents and 32 plastic stents )were analyzed retrospectively.Results There were remarkable effects on reducing the level of serum bilirubin and improving the symptoms.The bilirubin was decreased more obviously in the first week,and tended to normal in 3 weeks.Stenting was performed on upper bileduct obstruction mostly(accounted for 52.7%).The early complications were less;late complications were blockage mainly.The half-year obstructive rate in metal stent group was 19%;plastic stent 25%.Average stent patency was 214 days in metal stent versus 122 days in plastic stent.Conclusion Endoprotheses are an efficient means of treating malignant biliary strictures and reducing the level of serum bilirubin,particularly of upper biliary obstructions.As its micro-invasion,it is fit for old age and asthenic (such as dyscrasia),whose survival time may be shorter(estimated less than 6 months),doctor may choose metal stent.If patient is impoverished,the doctor could use plastic stent.

The low mass cutoff ( LMCO) is the main weakness of ion trap when it performs tandem mass analysis by collision induced dissociation (CID). LMCO means that some daughter ions of m/ z are less than about 1 / 3 of the m/ z of parent ion could not be detected during the tandem mass spectrometry processing. A new method which can significantly improve the effect of low mass cutoff was proposed and investigated. By simply changing the scan method of digital potential frequency, some low mass ions can be effectively observed during the tandem mass spectrometric experiment. In the experiment, the frequency of the digital ion trapping power and ion activation power were scanned from lower value to higher value, and some lower mass product ions could be detected during CID process. For example, some lower mass ions were observed during the CID of reserpine precursor ion when the frequency of its digital trapping power was scanned from 500 kHz to 560 kHz. The tandem mass spectra of Reserpine ion showed that the experimental results both from this work and the triple quadrupole mass spectrometer were exactly the same.

The age of 18 is an important criterion in judicial trial, immigrant and competitive sports. Consequentially, the estimation of age 18 is a key issue in forensic practice and research. The extremitas sternalis claviculae, iliac crest, third molar, and the proximal limb of the limb bone were usually used as indictors of age 18. The results of the previous studies demonstrated that those indictors could be beneficial to the estimation of age 18. The X-ray, CT, ultrasound and MRI of different indictors were widely utilized for the estimation of age 18, particularly the thin-layer CT. But due to the non-radiation, MRI will be a trend for forensic age estimation in the future. Whilst in the previous studies, the descriptive analysis was applied for the estimation of age 18, but due to the low statistic efficiency, it is unsuitable for forensic age estimation, and the future studies should pay attention to the high efficiency statistical methods, for instance, the ROC curve or the data mining.

Objective:To correlate bone mineral density with serum bone metabolism indexes in patients with hyperthyroidism.Methods:Thirty patients with hyperthyroidism who received treatment in the General Hospital of Taiyuan Iron and Steel (Group) Co., Ltd. from January 2018 to August 2019 were included in the hyperthyroidism group. Additional 30 healthy subjects who concurrently received routine physical examination were included in the control group. Bone mineral density in all subjects was measured by dual energy X-ray absorptiometry. Bone metabolism indexes in all subjects were measured using a Roche chemiluminescence instrument: 25-hydroxyvitamin D level [25(OH)D], aminoterminal propeptide of type I procollagen (PINP) and beta-cardiotoxin (β-CTX). Correlation between bone mineral density and serum bone metabolism indexes was analyzed using Spearman method.Results:Bone mineral density in lumbar vertebrae 1-4 [(0.86 ± 0.14) g/cm 3], left femoral neck [(0.79 ± 0.07) g/cm 3] and left hip joint [(0.72 ± 0.10) g/cm 3] in the hyperthyroidism group was significantly lower than that in the control group [(1.28 ± 0.21) g/cm 3, (1.03 ± 0.18) g/cm 3, (0.86 ± 0.13) g/cm 3, t = 9.115, 6.806, 4.675, all P < 0.001]. There were 6 cases of osteoporosis, 12 cases of osteopenia and 12 cases of normal bone in the hyperthyroidism group. There was 1 case of osteoporosis, 6 cases of osteopenia and 23 cases of normal bone in the control group. There was significant difference in the number of cases developing osteoporosis between hyperthyroidism and control groups ( Z = 2.968, P < 0.05). Serum level of 25(OH)D in the hyperthyroidism group was significantly lower than that in the control group [(16.89 ± 4.31) μg/L vs. (24.13 ± 5.48) μg/L, t = 5.688, P < 0.001]. Serum levels of PINP and β-CTX in the hyperthyroidism group were significantly lower than those in the control group [PINP: (49.37 ± 10.23) μg/L vs. (47.68 ± 6.49) μg/L; β-CTX: (774.56 ± 159.67) ng/L vs. (534.32 ± 167.48) ng/L, t = 45.974 and 5.687, both P < 0.001]. In the hyperthyroidism group, bone mineral density at lumbar vertebrae 1-4, left femoral neck and left hip joint was positively correlated with serum level of 25(OH)D ( r = 0.417, 0.396, 0.401, all P < 0.05), and it was negatively correlated with serum levels of PINP and β-CTX ( r = -0.414, -0.399, -0.432, -0.404, -0.387, -0.412, all P < 0.05). Conclusion:Hyperthyroidism patients generally have low bone mineral density and accelerated bone metabolism. It is of great significance to regularly monitor bone mineral density and serum bone metabolism indexes in hyperthyroidism patients to prevent osteoporosis.

OBJECTIVETo review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic value of different imaging methods.

METHODSOne hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Plain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively.

RESULTSA total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thoracolumbar burst fractures, leading to delay in diagnosis.

CONCLUSIONIn regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression fractures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; diagnosis ; pathology ; Thoracic Vertebrae ; diagnostic imaging ; injuries ; Tomography, X-Ray Computed

Objective To investigate the efficacy and safety of hypertonie saline enhanced radiofrequency ablation (RFA) in the treatment of liver cancer. Methods The clinical data of 42 patients with primary liver cancer (n = 28) or metastatic liver eancer (n = 14) who had been admitted to First Affiliated Hospital of Nanjing Medical University from September 2001 to December 2007 were collected. Forty-eight lesions were detected with a diameter ranging from 1.2 cm to 7.5 cm. RFA electrode and 20G needle were pricked into the target lesion under the guidance of B ultrasound or computed tomography (CT) through percutaneoas puncture or open approaches. An amount of 5-10 ml hypertonie saline was infused through the needle at regular intervals during RFA. All patients were followed up for 3-79 months. Contrast-enhanced ultrasound and CT scanning were performed postoperatively to determine the efficacy of RFA. The levels of alpha-fetoprotein (AFP) before and after treatment were compared using t test, and the survival of the patients were analyzed using a Kaplan-Meier survival curve. Results The AFP expression changed to negative in 14 out of the 18 AFP-positive patients, with statistical difference (t =7.703, P <0.05). The complete necrosis rate of tumors was 94% (45/48), and the necrosis rate of tumors with diameter of ≤4.0 cm reached 100% (35/35). The incidence of complication was 5% (2/42). No perioperative mortality occurred. The 1-, 2-, 3-year survival rates were 91%, 85% and 70%, respectively. Conclusions Hypertonic saline enhanced RFA in the treatment of liver cancer was proved to be safe and effective.

Objective To study the recovery mechanism of dysphagic patients after stroke using functional magnetic resonanee imaging(fMRI). Methods Thirteen patients with dysphagia caused by unilateral cortical or subcortical lesions were recruited into a dysphagia group,and eight age-matched healthy volunteers were recruited as controls.Both grouDs performed experimental volitional swallowing tasks during fMRI studies.All patients of the dys-phagia group received rehabilitation treatment targeting dysphagia.Of the 13 dysphagia patients,7 reached almost complete recovery and were identified as recovered in follow-up fMRI studies.A 3.0 T MR scanner and echo planar imaging(EPI)T_2 WI sequence were employed to obtain the fMRI data.SPM2 software was used for post-processing of the fMRI data and displaying activated brain maps.Lateral index(LI)was calculated as LI:(C-1)/(C+I).Paired t tests were used to compare activated brain volume before and after complete recovery. Results Consistent activation of the bilateral primary sensorimotor cortex,anterior cingulated gyrus and the bilateral insular cortex were observed in the control group. Activation of the pons,medulla,left cerebellum,left prefrontal area,right occipital area and the left insular cortex were observed in the dysphagia group.Activation was observed in the bilateral primary sensorimotor cortex.bilateral prefrontal area,bilateral superior temporal gyrus,left insular cortex,bilateral frontal o-pereulum and anterior cingulated gyrus in the recovered patients.The total activated volume before recovery in the ip-silesional hemisDhere was significantly less compared with the contralesional hemisphere in the dysphagia group.In the recovered patients,both the activated brain volume of the ipsilesional hemisphere and value of LI were significant-ly larger than those at the initial examination.Conclusions Decreased activation in the sensorimotor cortex,the in-sular lobe and the cingulate gyms might be causes.of dysphagia.Compensation by the contralesional hemisphere in the early stages and then the restoration of the ipsilesional hemisphere after recovery may be mechanisms of dysphagia recovery in stroke patients.