Objective To evaluate the characteristics of CT, MRI, PET and histopathology of brain radiation injuries following radiotherapy for nasopharyngeal carcinoma. Methods We reviewed the imaging records of 71 patients with brain radiation injuries following radiotherapy for nasopharyngeal carcinoma examined over a 10 year period. Results The radiation injury lesions occurred in the temporal lobes, brain stems or cerebella. Their CT appears were homogeneous or heterogeneous density. If the lesions situated in temporal lobes, they presented as "finger like" hypointensity. Twenty three patients(29 lesions) undenwent contrast enhanced CT scan, 86.2 percent(25/29)of the lesions showed no enhancement. MRI demonstrated prolonged T 1 and T 2 relaxation time of the injured tissue, they might showed homogeneous or heterogeneous signal intensity. MR enhanced T 1WI were performed in 20 cases(29 lesions),and 65.5 percent(19/29)of the lesions presented "Flower lace" enhancement. Two patients were carried on PET scan. One patient′s PET appearance is similar to the CT or MRI finding. Resections and histopathologic observations of temporal lobes′ lesions were performed on 3 cases, which showed cerebral necrosis. Conclusion (1) MRI plain or contrast enhanced scan is more sensitive than that of CT or PET. (2)The heterogeneous signal intensity on T 1WI and T 2WI represent necrosis,and all are located in the radiation field. (3)"Flower lace" enhancement on contrast MRI is the characteristic of brain radionecrosis. (4)PET may serve as a complementarity in the diagnosis of radiation induced injuries.

OBJECTIVE:To provide reference for the standardization of package insert of common drugs for elderly patients. METHODS:Outpatient prescriptions in our hospital from 2013 to 2014 were collected,and common drugs of elderly patients(≥60 years old)were ordered by consumption sum,and package inserts of top 100 drugs were statistically analyzed for absent items. RESULTS:The 100 common drugs for elderly patients included 28 Chinese traditional drugs and 72 chemical drugs. The Chinese traditional drug had more absent items,mostly were pharmacokinetics and drug overdose(92.9%),medication of elderly patients (85.7%),drug interactions(78.6%)and pharmacological actions(50.0%);the proportion of contraindications(16/28),adverse re-actions(15/28) and precaution(9/28) with uncertainty was relatively high. Items of chemicals package insert were better than Chi-nese traditional drug,absent items were pharmacokinetics and drug overdose(5.6%),medication of elderly patients and pharmaco-logical actions (2.8%) and drug interactions (1.4%);the proportion of medication of elderly patients (16/72),drug interaction and drug overdose(12/72)with uncertainty was relatively high. CONCLUSIONS:The common problem existing in the drug manu-al is characterized by absence of usage for elderly,drug descriptions is not clear,etc. Package inserts should be further improved to strengthen its standardization.

BACKGROUND: Although the sternohyoid muscular valves are traditionally used as reparative material for functional reconstruction after partial laryngectomy, the late-term results are not so satisfactory.OBJECTIVE: To investigate the efficacy of using external layer mucoperiosteum valve of thyroid cartilage to repair the wound surface and reconstruct vocal function.DESIGN: A self-controlled observational trial using the patients as subjects.SETTING: Department of otolaryngology of a municipal hospital.PARTICIPANTS: A total of 57 patients with laryngocarcinoma were selected from the Department of Otolaryngology, Shantou Second People' s Hospital, from June 1998 to May 2004. Among them, there were 56 men and 1 woman who were aged 37 to 78 years with the average age of 60. 38 years and whose disease duration was two months to one year with the average of five months.METHODS: In the 57 patients with laryngocarcinoma, their external layer mucoperiosteum valves of thyroid cartilages in the affected side were preserved and inverted into laryngeal cavities, which were used to cover the wound surface and rebuild the vocal fold.MAIN OUTCOME MEASURES: The final outcome indices: changes in the symtoms and function and Karnofsky scores before and after treatment. Risk indices: adverse events and side effects.RESULTS: The operations on the 57 patients were successful. The incidence of respiratory tract obstruction and hoarseness in the patients before operation was 38.9% and 98. 1%, but 1.9% and 96. 3% after treatment. Karnofsky score was 40 and 70 before and after treatment, respectively. No complications of pharyngeal stricture occurred in the near and long term.CONCLUSION: Vertical partial laryngectomy and laryngeal reconstruction with mucoperiosteum valve are easy to operate. The recovery of the wound surface is good, phonation efficacy is satisfacory, and respiratory function is not affected. The treatment has low incidence of complications and satisfactory long-term results.

Objective The aim of this article is to research the radical mastoidectomy and primary tympanoplasty to attain radical cure of the mastoid focus as well as rebuilding the sound- conducting structure of the tympanic cavity to improve the audition. Method The autobone and temporal fascia were taken as the transplants after the radical mastoidectomy under microscopy, and then to carry out the operation of Portmann｀ s tempanoplasty of 2nd and 3rd types of 2nd class.Result Non of the cholesteatoma was relapsed after follow- up for 1～ 4 years.The efficiency rate of tympanoplasty is of 89.47% .The average audition increased was 19 dB HL. Conclussion Radical operation for cholesteatoma should be associated with tympanoplasty if having condition. We recommend that the opening tympanoplasty should be used, and use autobone as a artificial auditory ossicles.

BACKGROUND:Techniques of antedor cervical discectomy and interbody fusion have achieved good clinical outcomes since Robinson and Smith first introduced it in 1955.Currently,microendoscopic approaches have resulted in good clinical effectiveness in treating cervical spondylosis.Cage has also been used widely in the clinic.OBJECTIVE:To find a minimally invasive method that uses microendoscopic technique and Cages to treat cervical spondylosis by anterior approach.DESIGN,TIME AND SETTING:A retrospective case analysis was performed at the Department of Spinal Surgery,First Affiliated Hospital of University of South China between January 2003 and July 2008.PARTICIPANTS:A total of 25 patients with cervical spondylosis,15 males and 10 females,averaging 39 years of age (range,33-58 years old),who received treatments at the Department of Spinal Surgery,First Affiliated Hospital of University of South China were included in this study.Each of them had unilateral limb pain,numbness or weakness in varying degrees.MRI image showed one-level cervical disc degeneration in 20 patients and two levels in 5 patients.METHODS:Twenty-five patients underwent anterior cervical microendoscopic discectomy and interbody fusion using carbon fiber reinforced polymer (CFRP) Cage.Surgical techniques,neurological outcomes and complications were retrospectively analyzed.The postoperative treatments were just like the conventional approaches.MAIN OUTCOME MEASURES:Improvements in neurological symptoms were assessed using the Japanese Orthopedic Association (JOA) grading system.Postoperative imaging data including lordosis and fusion condition were examined.RESULTS:All patients received treatments successfully.The mean surgical time was 140 minutes (range,80 to 225 minutes).The hospital stay averaged 7 days (range,6 to 10 days).Patients' neurological statuses improved to varying degrees according to the JOA grading system:7.5 pre-operative (range,4 to 9 points) to 12 post-operative (range,8 to 16 points),with the mean improvement rate of 45.6%.All cases were followed up and the mean follow-up period was 18 months (range,6 to 27 months).Postoperative images showed solid bone fusion without implant migration.No vascular injury and infection occurred.Graft collapse was found in 2 patients,and transient hoarse voice in 1 patient.No other complications were found.CONCLUSION:Anterior microendoscopic cervical discectomy and interbody fusion with CFRP Cage in treatment of cervical spondylosis have the advantages of minimal invasion,sufficient decompression,and satisfactory bone fusion,resulting in a significant relief of patients' preoperative clinical symptoms.

To investigate the effects of Tangshenling Mixture (TSLM) and benazepril on rats with diabetic nephropathy (DN) and its mechanism.

OBJECTIVE: To observe the effects of Shengqing Capsule (SQC), a compound of traditional Chinese herbal medicine, on biochemical parameters in C57BL/6J mice with cholesterol gallstone. METHODS: Thirty-eight C57BL/6J mice were randomly divided into normal control group (n=10), untreated group (n=15) and SQC group (n=13). Cholesterol gallstone was induced in mice of the latter two groups by feeding high cholesterol diet. Mice in the SQC group were intragastricly administered SQC 0.22 g/(kg.d). After 8-week treatment, animals were sacrificed and sampled to calculate the incidences of stone formation. The contents of serum cholesterols and Ca(2+), and the malonaldehyde (MDA) content and superoxide dismutase (SOD) activity in liver tissues were detected. RESULTS: The incidences of stone formation were 73.33% in untreated group, 0% in normal control group, and 23.08% in the SQC group. And the INCIDENCE in untreated group was significantly higher than those in the normal control group and the SQC group (P<0.01). Contents of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the SQC group were lower than that in the untreated group (P<0.01), and high-density lipoprotein cholesterol (HDL-C) in the SQC group was higher than that in the untreated group (P<0.01). SQC could increase the SOD activity and decrease the MDA content in liver tissues, showing significant differences as compared with those in the untreated group (P<0.05). CONCLUSION: SQC can decrease the incidence of stone formation and improve the biochemical parameters, which may be one of the mechanisms in the treatment and prevention of cholesterol gallstone disease.

Objective To assess the safety and efficacy of mycophenolate mofetil (MMF) combined with low dose corticosteroid in the treatment of adults with minimal change nephrotic syndrome and concomitant HBsAg positive (MCNS-HBsAg). Methods Thirty adults with MCNS-HBsAg were enrolled in this prospective study and were assigned to two groups. The MMF group (n=14) received low dose of prednisone combined with MMF (MMF 1.0 to 2.0 g/d patients of Pred group versus 35.7% patients of MMF group. 43.8% patients of Pred group versus 21.4% patients of MMF group received lamivudine therapy. Elevation of alanine aminotransferase(ALT) ocurred in 50% patients of Pred group and 28.6% patients of MMF group. The complete remission (CR) rate after 24 weeks treatment was 11/14 in Pred group versus 10/12 in MMF group. 6/11 patients of the Pred group and 4/10 patients of the MMF group who achieved CR experienced relapses during follow-up. Conclusions Use of MMF combined with low dose prednisone is as effective as conventional prednisone regimen in treating adults with MCNS-HBsAg. The MMF protocol seems to be superior in HBV reactivation to conventional prednisone protocol.

Objective: To investigate the nutritional status and its relationship with the indexes of physical function and physical capacity among primary and middle school students in Xiamen, so as to provide statistical support for improving their nutritional status and physical health. Methods: A total of 2 752 primary and middle school students aged between 6 and 18 years old were selected in Xiamen. They were divided into malnutrition group, normal group and overweight and obesity group according to the national standards. Statistical analysis was carried out by chi square test, Kruskal wallis test and partial correlation analysis. Results: The prevalence of malnutrition among primary and secondary school students in Xiamen was 8.4%(231), the prevalence of overweight and obesity was 24.2%(667), and the prevalence of overweight and obesity among boys(31.4%) was higher than girls( 17.0 %).The distribution of nutritional status between different ages was statistically significant ( χ 2=40.43, P <0.05). On the lung activity index, both boys and girls were shown to be overweight and obesityConclusion The prevention and control situation of overweight between primary and secondary school students in Xiamen city, is more serious. Overweight and obesity are related to decline in physical function and physical fitness. Nutritional status should be paid more attention for physical fitness improvement among students.

Objective To understand the patterns of outpatient prescription medications in the hospital's elderly patients.Methods Data for all outpatient prescriptions at our hospital written for seniors (≥60 years old) between 2013 and 2014 were collected and medications were ranked based on the price.The top 100 medications were chosen for analysis.Results The most expensive and most frequently prescribed three therapeutic groups were drugs for cardiovascular,endocrine & metabolic,and bone & joint disorders.Medication numbers and prices varied among different age groups,with the 60-64 and 75-79 groups representing the highest numbers and prices.The average price (460.3 yuan) per prescription for male patients was higher than that (399.3 yuan) for female patients.Conclusions The cost of prescription drugs in elderly patients is higher than in middle-aged patients,with drugs for non communicable chronic diseases accounting for most of the expenses.Polypharmacy is also a prominent issue.Prescriptions for chronic illnesses in the elderly should follow well established guidelines and appropriately managed.