Objective To investigate the clinical effects,complications and cautions for transcatheter supperselective internal maxillary artery and facial artery embolization for treatment of intractable epistaxis.Methods Eight patients with intractable epistaxis underwent transcatheter supperselective internal maxillary artery and facial artery embolization.Results Immediate hemostasis was obtained in all patients,while varying degrees of headache were observed,but no serious complications occurred.Conclusion Transcatheter supperselective internal maxillary artery and facial artery embolization is a safe,effective method for the treatment of intractable epistaxis.

Objective To study the changes of transforming growth factor-β1(TGF-β1) in pulmonary fibrosis induced by paraquat (PQ) with immunohistochemistry method. MethodsA total of 58 C57BL/6J male mice were randomly (random number) divided into the experimental group and control group. Pulmonary fibrosis was induced by intra-peritoneal injection of PQ in dose of 10 mg/kg into the mice of experimental group (n = 48), while physiological saline was used instead in mice of control group (n = 10). The mice of experimental group were sacrificed 2, 5, 7 and 14 days after PQ poisoning and the mice of control group were sacrificed on the 7th day after saline administration. Lungs of mice were taken and histological changes in lungs were evaluated by haematoxylin-eosin stain, and TGF-β1 was determined with immunohistochemistry method. The integrated optical density (iOD) value of TGF-β1 was measured and analyzed. ResultsThe TGF-β1 was markedly increased in macrophages during the genesis of pulmonary fibrosis induced by PQ. As the course of fibrosis progressed, the positive staining of TGF-B1 was mainly seen in macrophages and neutrophil's cytoplasm. On the 14th day after PQ poisoning, TGF-β1-positive cells were also detected in the fibroblast and myo-fibroblast inside the fibroblastic foci. Compared with the control group, the iOD value of TGF-β1 increased in experimental group (P ＜ 0. 01 ) and it gradually upgraded during the course of fibrosis. Conclusions The TGF-β1 significantly increased during the course of pulmonary fibrosis induced by PQ and played an important role in the pathogenesis of the disease.

Objective To analyze analgesics administration from July 2005 to July 2006 in emergency rooms of the First, the Second and Fourth Affiliated Hospitals of China Medical University in order to provide a reference for clinically rational administration. Method The data of 2313 prescriptions with analgesics administered during one-year period were analyzed in many respects including the overview of the prescriptions, the frequency of anal-gesics administration, the system of defined daily doses (DDDs) and drug utilization index (DUI) of narcotic anal-gesics were analyzed, and a survey of 200 patients managed with some of those analgesics was done by using ques-tionaire as they were admitted to and discharged from the emergency room. The pain intensity was evaluated by a 10-point numerical rating scale (NRS). The respondents, excluding the mute or deaf, police custody, victims of domestic violence,mental disorder and age under 14,rated the levels of satisfaction with medication for pain relief. The data of frequency and percentage of the administration of analgeics were analyzed,and the scores of NRS were evaluated with the Paired-samples t -test. Results Most of analgesics were in the form of parenteral route usage, of which anisodamine and bucinnazine were employed in large proportion, and a small number of them was in the form of tablets. Trauma was the commonest cause of pain. Of the narcotic analgesics, meperidine was the most com-monly used analgesics, and its DDDs and DUI were much lower than that of WHO limits. Of the 200 patients, 71.5% patients rated a considerably high satisfaction with scores of (7.47 ±2.21) and (5.00 ± 3. 16) by NRS before and after medication,respectively ( ( -value 23.38,P < 0.01) .The patients presenting pain intensity with a scores of 4 or greater accounted for 57.5% . Conclusions The patients suffering from pain could lie rationally treated in the emergency rooms of those three hospitals. Narcotic analgesics should be cautiously employed, and there is room for improvement in pain management practice in emergency room.

Objective To investigate the levels of estrogen,progesterone,follicle-stimulating hormone (FSH),and luteinizing hormone (LH) in serum and the expression of ER,PR,FSH receptor (FSHR),and LH receptor (LHR) in thyroid tissues of patients with different types of thyroid nodules.Methods Serum levels of estrogen,progesterone,FSH,and LH were measured by chemiluminescence and expression of ER,PR,FSHR,and LHR in thyroid tissue was detected by immunohistochemistry in female patients with thyroid adenoma (n＝97),nodular goiter (n＝103),thyroid papillary cancer (n＝208),poorly differentiated thyroid carcinoma (n＝17),or undifferentiated thyroid carcinoma (n＝10) and in normal controls (n＝60) from Dec.2009 to Dec.2014 in Department of Thyroid Surgery of the First Hospital of Jilin University.Results The positive rates of serum estrogen level and ER expression were significantly greater in patients with various types of thyroid nodules than in normal controls.The positive rates of ER expression were significantly lower in various types of thyroid nodules than in normal thyroid tissues,especially in poorly differentiated carcinoma and undifferentiated carcinoma.The negative rates of serum progesterone level and positive rates of PR expression in thyroid tissue were significantly greater in patients with thyroid adenoma,nodular goiter,or thyroid papillary cancer than in normal controls.The positive rates of serum FSH and LH levels and FSHR and LHR expression were significantly greater in the thyroid adenoma group than in other groups.Conclusions The occurance of thyroid nodules might be related to sex hormone.The combined detection of serum levels of sex hormones and expression of their receptors allows for a differential diagnosis and evaluation of the degree of differentiation among various types of thyroid nodules.

Objective To investigate the clinical efficacy of transarterial chemoembolization (TACE) combined with sorafenib for the treatment of inoperable hepatocellular carcinoma (HCC), and to discuss the influence of treatment interval on the survival time. Methods During the period from July 2008 to May 2011 at authors’ hospital, a total of 50 patients with inoperable HCC were treated with TACE together with sorafenib. The treatment intervals between each TACE procedure were recorded. The results were analyzed. Results Up to Dec. 31, 2011, the median follow-up time of the 50 patients was 310 days. The mean interval between TACE treatments was 69 days before the combination treatment was employed , while the mean interval was 112 days after the combination treatment started , and the longest interval was 648 days. Conclusion Combination treatment TACE with sorafenib can remarkably prolong the treatment interval in patients with inoperable HCC, thus the patient can get more survival benefits.

Objective To investigate the application of C- arm CT imaging technique in evaluating the efficacy of transarterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). Methods During the period from Sep. 2012 to Mar. 2013 at authors’ hospital, C- arm CT scanning was employed during the performance of TACE in 80 patients with HCC. The residual active tumor lesions, Lipiodol deposition and the embolization of the feeding arteries after TACE therapy were assessed by C- arm CT plain scan images and the images of early artery phase and parenchymal phase, as well as the post- processing images. The efficacy of TACE was thus evaluated. Results A total of 139 hepatic tumors were detected in 80 patients by C- arm CT imaging. C- arm CT scanning performed immediately after TACE showed that satisfactory result was obtained in 128 lesions of 75 patients(128/139, 92.9%). Fewer, medium and more residual active tumors were seen in 78, 29 and 21 lesions respectively, while dense, moderate and thin Lipiodol deposition was seen in 64, 39 and 25 lesions respectively. After TACE therapy obvious decrease in blood supply was demonstrated in 101 lesions, while no obvious decrease in blood supply was seen in 27 lesions. Conclusion C- arm CT scanning after TACE for patients with HCC can conveniently, accurately and comprehensively reveal the residual active tumors, Lipiodol deposition and embolization status of feeding arteries. Therefore, this technique should be regarded as an important means to evaluate the efficacy of TACE.

Objective To evaluate the value of the mRECIST criteria in assessing the efficacy of transcatheter arterial chemoembolization(TACE) combined with sorafenib in the treatment of hepatocellular carcinoma (HCC).Methods A total of 35 patients who were treated with a combination of TACE and sorafenib for unresectable hepatocellular carcinoma fulfilled the mRECIST and RECIST criteria in our hospital from June 2011 to November 2012.Enhanced CT and/or enhanced MRI were used before (baseline) and after (3 month reexamination) combination treatment in our hospital.The mRECIST and RECIST criteria were used to evaluate the efficacy,and these efficacy assessments were compared.Results In the RECIST criteria,complete remission (CR) was 0％,partial remission (PR) was 2.9％,stable disease (SD) was 85.7％％,and progressive disease (PD) was 11.4％％.In the mRECIST criteria,CR was 8.6％,PR was 51.4％,SD was 34.3％,and PD was 5.7％.For the RECIST criteria,the objective response rate (CR+-PR) was 2.9％,the disease control rate (CR+PR+SD) was 88.6％,and the disease progression rate was 11.4％.For the mRECIST criteria,the objective criteria was 60％,the disease control rate was 94.3％,and the disease progression rate was 5.7 ％.The difference between the efficacy assessment results of mRECIST and RECIST was statisti cally significant(P＜0.001).Conclusion The mRECIST criteria can evaluate the efficacy of target le sions based on viable tumors,which is more adaptive to TACE and targeted drugs with new mecha nisms.

Objective To investigate the clinical effect of mild hypothermia on neonatal bilirubin encephalopathy, and the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and amplitude integrated electroencephalogram (aEEG) for diagnosis and evaluation of curative effect. Methods From May, 2013 to December, 2014, 29 newborns with bilirubin encephalopathy were divided into conventional group (n=15) and mild hypothermia group (n=14). The conventional group received conventional therapy, and the other group received mild hypothermia in addition. The aEEG and neuron-specific enolase (NSE) were measured before and after treatment, as well as the glucose metabolism rate with 18F-FDG PET/CT after treatment. Results The NSE was lower after treatment in both groups (t>9.670, P<0.001), and was lower in the mild hypothermia group than in the conventional group (F=46.146, P<0.001). After treatment, sleep-wake cycle (SWC), epileptiform activity and the degree of abnormality were obviously improved (P<0.05), and were better in the mild hypothermia group than in the conventional group (P<0.05). The cerebral glucose metabolism rate was significantly better in the mild hypo-thermia group than in the conventional group (t>2.943, P<0.01). The cerebral glucose metabolism rate was negatively correlated with aEEG and NSE (r>0.640, P<0.05). Conclusion Mild hypothermia therapy could further promote the energy metabolism of brain cells in neonatal bilirubin encephalopathy. 18F-FDG PET/CT and aEEG can be used for early diagnosis and therapeutic evaluation.

Objective To evaluate the role of p38MAPK signaling pathway in electroacupuncture (EA)-induced reduction of acute lung injury (ALI) in rabbits with endotoxic shock and the relationship with nuclear factor E2-related factor 2 (Nrf2).Methods Seventy healthy male New Zealand white rabbits,aged 2 months,weighing 1.5-2.5 kg,were randomly divided into 7 groups (n=10 each) using a random number table:control group (group C),endotoxin-induced ALI group (group A),p38MAPK inhibitor SB203580 group (group SB),ALI + SB203580 group (group A-SB),ALI + EA group (A-EA group),ALI + EA at non-acupoint group (A-NEA group) and ALI + EA at acupoints+ SB203580 group (A-EA-SB group).The rabbits were anesthetized with urethane and tracheostomized and kept spontaneous breathing.Right common carotid artery was cannulated for mean arterial pressure monitoring.The auricular vein was cannulated for drug administration.Bilateral 30 min EA (wave length 0.2-0.6 ms,frequency 2/100 Hz,intensity ≤ 1-2 mA) stimulation of Zusanli and Feishu was performed once a day for 4 days before establishment of the model and during establishment of the model in A-EA and A-EA-SB groups.In group A-NEA,EA was performed at the points 0.5 cm lateral to the acupoints of Zusanli and Feishu according to the method previously described in group EA.In A,A-SB,A-EA,A-NEA and A-EA-SB groups,ALI was induced by endotoxin (5 mg/kg) injection,while the equal volume of normal saline was given in C and SB groups.After establishment of the model,SB203580 5 μmol/kg was injected intravenously in SB,A-SB and A-EA-SB groups,the equal volume of normal saline was given in group C,and the equal volume of dehydrated alcohol was given in the other groups.At 6 h after endotoxin or normal saline administration,arterial blood samples were collected for blood gas analysis.The rabbits were then sacrificed,and lungs were removed for microscopic examination and for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,and expression of phosphor-p38MAPK (p-p38MAPK) and Nrf2 in lung tissues.The pathological changes of lungs were scored.Wet to dry lung weight ratio (W/D ratio) was calculated.Results Compared to group C,the pathological scores,W/D ratio,MDA content,and expression of pp38MAPK and Nrf2 were significantly increased,and SOD activities were decreased in A,A-SB,A-EA,ANEA and A-EA-SB groups.Compared to group A,the pathological scores,W/D ratio and MDA content were significantly decreased,and SOD activities and expression of p-p38MAPK and Nrf2 were increased in A-EA group.Compared to group A-EA,the pathological scores,W/D ratio and MDA content were significantly increased,and SOD activities and expression of p-p38MAPK and Nrf2 were significantly decreased in group A-EA-SB.Conclusion p38MAPK signaling pathway mediates EA-induced reduction of ALI in rabbits with endotoxic shock,and up-regulated expression of Nrf2 is involved in the mechanism.

Objective To evaluate the effect of Budesonide combined with Poractant Alfa(pulmonary surfactants,PS) on preventing the bronchopulmonary dysplasia (BPD) in preterm infants.Methods One hundred and twenty preterm infants 6 hours after birth(gestational ages≤32 weeks and birth weights ≤1500 g)admitted to the Department of Newborn Medicine,the Affiliated Hospital of Southeast Medical University from October 2013 to February 2015 were randomly divided into 4 group(30 cases in each group).Group A was a control group,group B was neonatal respiratory distress syndrome(NRDS) group,group C was NRDS with PS group,and group D was NRDS with PS and Budesonide group.Thirty-two-week preterms without other diseases and without uptaking oxygen within 48 h were assigned as group A.Group B were treated by continuous uptaking oxygen with continuous positive airway pressure(CPAP) (oxygen uptaken lasting more than 48 h and oxygen concentrations more than 40％).Group C were treated with 100 mg/kg PS within 48 h on the basis of group B.Group D were treated with 0.25 mg/kg Budesonide suspension for inhalation on the basis of group C.The pH value,partial pressure of oxygen [pa(O2)],partial pressure of carbon dioxide [pa(CO2)] in the blood gas analysis were all detected in all groups before treatment,1,6,12,24 and 48 hours after using drug,respectively.All groups were also observed for whether to use respirator assisted ventilation,the duration of high oxygen use,the total time of uptaking oxygen,the rate of using PS again,the rate of BPD,the total hospitalization days and the adverse effects.The adverse effects included high blood pressure,high blood sugar,necrotizing enterocolitis and the incidence of nosocomial infection.Results Compared with group B,the pH value at 1 and 6 hours after using drugs,the pa(O2) and pa(CO2) at 1,6 and 12 hours after using drugs were improved obviously in the group C,and the differences were statistically significant (all P＜0.01).Compared with group B,the above indicators were improved more obvious in group D,and the differences were statistically significant (all P＜0.01).Moreover,compared with the group B,the oxygen inhalation duration,the rate of having a respirator assisted ventilation and using PS again,and the incidence of BPD were obviously decreased in other groups,the differences were statistically significant (all P＜0.05).The incidence of BPD in group D was less than that of group C,and the differences were statistically significant (3.33％ vs 10.00％,x2=4.00,P=0.046).The total oxygen time and the rate of adverse effects of each group were similar.The differences were not statistically significant (all P＞0.05).Conclusions Budesonide combined with Poractant Alfa can prevent BPD in preterm infants.Its effect is better than the simple use of Poractant Alfa,and the rate of adverse effects are not increased significantly.