OBJECTIVE An understanding of the complex anatomy of the anterior skull base is crucial for the surgeon doing endoscopic surgery. The anatomic data of the olfactory sulcus and adjacent structures in Chinese patients were defined using 3-dimensional reconstruction images. The surgeon is encouraged to develop a detailed pre-operative surgical plan by utilizing these dynamic anatomical observations to avoid intracranial injury. METHODS The paranasal sinus CT scanning images of 100 adults were reconstructed for observation using EBW2.0 software and multiplanar reformation. All data obtained were in the coronal plane from the anterior point of the olfactory sulcus. The cribriform plate depth as compared to the ethmoid roof and adjacent structures, was measured bilaterally. Data obtained on adjacent structures include the vertical height of the lateral lamella of olfactory sulcus, the horizontal distance between the cribriform plate and the orbital lamella, the length of the middle turbinate, the height of the orbit, and the vertical distance between the cribriform plate and the nasal floor. RESULTS The olfactory sulcus was classified into three types: platform type (60 %), sloping type (17 %) and mixed type(23 %), as distinguished from Keros classification. In this study the vertical height of the lateral lamella of olfactory sulcus was (5.03 ± 0.17) mm (R) and (5.39 ± 0.19) mm (L) in platform type, and (2.79 ± 0.49) mm (R) and (4.72 ± 0.49) mm (L) in the mixed type. There were statistically significant differences between the right side and the left side in these two types (P＜0.01). The horizontal distance between the cribriform plate and the orbital lamella on the same side was significantly different between the platform type and the mixed type of olfactory sulcus. A similar result was observed for the vertical distance between the cribriform plate and the nasal floor. Gender differences exist in the horizontal distance between the cribriform plate and orbital lamella on the same side and the vertical distance between the cribriform plate and the nasal floor. CONCLUSION Different types of olfactory sulcus have distinct characteristics, hence care which must be taken into account when doing endoscopic surgery.

Adult ; Chemical and Drug Induced Liver Injury ; Dimethylformamide ; poisoning ; Humans ; Liver ; pathology ; Liver Diseases ; blood ; pathology ; Male ; Necrosis ; Occupational Diseases ; therapy ; Poisoning ; pathology ; therapy

Background mental imagery is a multi-componential process involving different mental operations. Objective The present study investigated the subsystems of visual mental imagery processing and their interactions. Methods: Four experimental tasks were done: (1) object, the ability to generate global mental images; (2) resolution, the ability to generate vivid,high-resolution mental images; (3) transformation,the ability to mentally rotate patterns in images, and (4) spatial imagery,spatial cognition. 91 university students (77 males, 14 females) participated in this study. Results: Object task was highly correlated with resolution task, and the same the tendency was found between transformation task and spatial task. Conclusion: The results indicate there are different subsystems of visual mental imagery and corresponding operative strategies, but with strong correlation among these processes and abilities.

This study is to report the effect of OATP1B1 gene mutation in the 521T --> C in Chinese human on the pharmacokinetics of rosuvastatin and guide the reasonable clinical application of rosuvastatin by the feature of genetic polymorphism of OATP1B1. Plasma samples were determined with LC-MS: the analyte and internal standard pitavastatin were both analyzed by MS in the ESI, m/z was 480.0 for rosuvastatin and 420.0 for the IS, separately. Genotyping of OATP1B1 was determined with the method of polymerase chain reaction--amplification refractory mutation system targeted at 40 healthy volunteers and showed that there were 7 subjects with 521T --> C mutant, accounting to 17.5% of total and wild type homozygote accounted to 82.5%. It was found that there were significant differences between OATP1B1 mutation in the 521T --> C and wild type homozygote for rosuvastatin pharmacokinetic process in Chinese human. In contrast to OATP1B1 wild type group, OATP1B1 mutation group's absorption degree increased, elimination process decreased. The OATP1B1 mutation should be noted for guiding the reasonable application of rosuvastatin during its clinical use.
Asian Continental Ancestry Group ; genetics ; Exons ; Fluorobenzenes ; blood ; pharmacokinetics ; Genotype ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; blood ; pharmacokinetics ; Male ; Organic Anion Transporters ; genetics ; Point Mutation ; Polymorphism, Single Nucleotide ; Pyrimidines ; blood ; pharmacokinetics ; Rosuvastatin Calcium ; Solute Carrier Organic Anion Transporter Family Member 1b1 ; Sulfonamides ; blood ; pharmacokinetics

AIMTo study the chemical constituents of Tripterygium wilfordii Hook. F.

METHODSVarious column chromatographies with silica gel were used for the isolation and purification. The structures of compounds were established on the basis of its IR, MS, UV, 1H NMR, 13C NMR and HRMS, 1H-1H COSY, 1H-13C COSY and NOESY.

RESULTSFour diterpenoids were isolated: 16-hydroxytriptolide (I), triptolidenol (II), tripdiolide (III), 2-epitripdiolide (IV).

CONCLUSIONCompound IV is a new diterpenoid.

Diterpenes ; chemistry ; isolation & purification ; Molecular Structure ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Tripterygium ; chemistry

Objective To evaluate the accuracy of colposcopic biopsy on diagnosis of cervical adenocarcinoma in situ(AIS)and the clinical significance of loop electrosurgical excisional procedure (LEEP)on diagnosis and treatment of AIS and invasive adenocarcinoma.Methods All medical records of 193 patients diagnosed as AIS by colposcopic biopsy and(or)AIS or invasive adenocarcinoma diagnosed by LEEP conization from Jan. 2015 to Dec. 2016 in Obstetrics and Gynecology Hospital of Fudan University were retrospectively reviewed.The final diagnosis was based on colposcopic biopsy or LEEP or the highest grade of pathological diagnosis after hysterectomy. Results In the 193 patients, 155 cases were finally diagnosed as AIS and 38 cases as invasive adenocarcinoma by histopathologic examination.Among the 155 AIS patients,21.9%(34/155)had positive cone margins,in which 26 patients had hysterectomy,30.8%(8/26) had residual disease in hysterectomy specimens; 78.1%(121/155)had negative cone margins,68 patients with negative margins had hysterectomy and 5.9%(4/68)had residual disease, which was significantly lower than that with positive margins(χ2=10.46, P=0.001). One hundred and twenty from one hundred ninty-three(62.3%,120/193)with AIS were detected by colposcopy.Pathological diagnosis of 50.8%(98/193)cases were upgraded after LEEP conization. Conclusions Colposcopy is indispensable for the diagnosis of AIS, but accurate diagnosis should be made by LEEP. LEEP is capable of detecting AIS or cervical adenocarcinoma that was misdiagnosed by colposcopy, which is a pivotal method for accurate diagnosis. The margin status of LEEP is important for patients in choosing further hysterectomy, but the presence of cervical adenocarcinoma should always be aware of.

Objective To investigate the clinical significance of intact canal wall mastoidectomy combined with facial recess opening in the treatment of secretory otitis media of children. Methods The clinical data of 17 children ( 19 ears) with recurrent secretory otitis media yet failed tube insertion more than 3 times, and treated with intact canal wall mastoidectomy combined with facial recess opening, in the Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of SUN Yat-sen University, were reviewed. And because of the eustachian tube dysfunction, 7 ears simultaneously accepted tube insertion, which were removed after 1 to 3 months. Results Pathological examination of the lesions in middle ear and mastoid of the 19 ears, revealed cholesterol granuloma in 9 ears and inflammatory granulation in 10 ears. All 19 ears recovered with normal tympanic membranes. There were 16 ears with type A tympanogram and 3 ears with type C tympanogram ( negative pressure less than 150 mm H2O). The air-bone gaps were less than 15 dB in 3 months after surgery. There was no recurrence in all cases after 2 - 3 years follow-up. Conclusions In case of recurrent otitis media in children, especially when tube insertion is ineffective, intact canal wall mastoidectomy combined with facial recess opening can be adopted to clear the lesions thoroughly, and to establish long-time and effective ventilation of eustachian tube, tympanic cavity,tympanic antrum, and mastoid.

Objective: To investigate the efficacy and safety of CD19 chimeric antigen receptor T (CAR-T) lymphocytes for the treatment of B cell lymphoma. Methods: A total of 22 patients with B-cell lymphoma from February 1, 2017 to July 1, 2018 were reviewed to evaluate the efficacy and adverse reactions of CD19 CAR-T. Results: Of 22 patients with B-cell lymphoma received CD19 CAR-T cells, the median dose of CAR-T cells was 7.2 (2.0-12.0) ×10⁶/kg. Nine of 12 cases of relapse refractory patients were overall response. Complete remission (CR) occurred in 2 of 12 patients, partial remission (PR) in 7 of 12 patients. The overall response in minor residual disease positive (MRD) group was 8 of 10 patients. CD19 CAR-T cells proliferated in vivo and were detectable in the blood of patients. The peak timepoints of CAR-T cells proliferated in the relapsed refractory and MRD positive groups were 12 (5-19) and 4.5 (1-12) days after treatment respectively, and among peripheral blood cells, CAR-T cells accounted for 10.10% (3.55%-24.74%) and 4.02% (2.23%-28.60%) of T lymphocytes respectively. The MRD positive patients achieved sustained remissions during a median follow-up of 8 months (rang 3-18 months) . None of all the patients relapsed during a median follow-up time of 10 months (3-18 months) . However, 7 PR responders of the relapsed refractory patients maintained a good condition for 1.5-6.0 months. One patient bridged to hematopoietic stem cell transplantation, another one sustained remission for 12 months. Cytokine-release syndrome (CRS) occurred in 14 patients with grade 1-2 CRS in MRD positive group and grade 3 CRS in relapsed refractory group. Conclusions: CAR-T cell therapy not only played a role in the rescue treatment of relapsed and refractory patients, but also produced a surprising effect in the consolidation and maintenance of B-cell lymphoma. CD19 CAR-T cells might be more effective in the treatment of MRD positive B-cell lymphoma patients than in the refractory or relapsed cases. High response rate was observed with fewer adverse reactions.
Antigens, CD19 ; Humans ; Lymphoma, B-Cell ; Neoplasm Recurrence, Local ; Receptors, Antigen, T-Cell ; Receptors, Chimeric Antigen ; T-Lymphocytes

Objective To explore the detection trend of vaginal intraepithelial neoplasia(VaIN)of lower genital tract from 2013 to 2015. Methods A retrospective analysis was undertaken of colposcopy-directed biopsy of cervical, vaginal and vulvar intraepithelial neoplasia lesions include cervical intraepithelial neoplasia (CIN), VaIN and vulvar intraepithelial neoplasia (VIN) in Obstetrics and Gynecology Hospital of Fudan University from January 2013 to December 2015. Results (1) Overall data of CIN, VaIN and VIN:a total of 16732 cases were diagnosed of lower genital intraepithelial neoplasia in 3 years, accounting for 23.20% (16732/72128) of total colposcopy-directed biopsy cases. Among them, CIN, VaIN and VIN accounted for 19.48%(14053/72128), 2.67%(1923/72128), 1.05%(756/72128) of total colposcopy-directed biopsy cases of the lower genital tract, 83.99%(14053/16732), 11.49%(1923/16732), 4.52%(756/16732) of total lower genital intraepithelial neoplasia, respectively. (2) Annual data of CIN, VaIN and VIN from 2013 to 2015. The annual proportion of CIN in all intraepithelial neoplasia of lower gential tract was basically stable, consisting of 86.02%(3955/4598),83.25%(4795/5760) and 83.20%(5303/6374), respectively. The annual proportion of VaIN was gradually increasing, consisting of 8.09% (372/4598), 12.45%(717/5760) and 13.08%(834/6374), respectively. The annual proportion of VIN was gradually decreasing, consisting of 5.89% (271/4598), 4.31% (248/5760) and 3.72% (237/6374), respectively. Conclusion The increasing detection of VaIN from 2013 to 2015 might correlate with the increasing attention to inspection of the entire vaginal wall.

Objective To develop an evaluation index system on health information on the internet using Delphi method. Methods The index system on health information on the internet was drown up and then two rounds of 11 experts' questionnaire consultation were conducted using Delphi method to determine the index system. Results Of 11 experts, the mean age was 48.55±6.79, and 91.67％ of experts had high professional titles and had been working for average (23.64±10.10) years. The altive coefficient for the first and the second hound consultation was 91.67％ and 100.00％ respectively. The average coefficient of specialists authority was 0.75. After two round consultations, Kendalf's concordance coefficients were 0.39 (P<0.01) and 0.51 (P <0.01) , respectively. After two rounds of Delphi, the index system includes 3 from first-level indicators and 15 from secondary-level indicators. Conclusion Experts' representativeness, enthusiasm and professionalism brought to a consensus in developing an evaluation index system to be used in monitoring health information on the internet.