Background and purpose: The patients with nasopharyngeal carcinoma(NPC) are staged according to Chinese 1992 staging system that is mainly based on clinical symptoms and CT image.Since MRI has been widely used in the clinic,the results were reported to be more accurate than the CT scan.The purpose of this study was to compare the diversity in tumor extension of NPC by computerized tomography(CT) versus magnetic resonance imaging(MRI) and to evaluate if the difference has any impacts on the '92 staging system.Methods:The MRI and CT were taken and compared prior to radiotherapy for 78 cases with histologically proved NPC from Aug.2005 to Aug.2006.Clinical staging was estimated according to '92 staging system based on both of CT or MRI data and clinical information.Results:MRI was significantly superior to CT in the detection of invasion in anterior-styloid space(82.0% vs 65.4%),oropharynx(34.6% vs 20.5%),retropharyngeal lymphatic metastasis(74.4% vs 55.1%),base of skull(51.3% vs 30.8%),cavernous sinus(19.2% vs 5.1%),nasal sinuses(33.3% vs 19.2%) and pterygopalatine fossa(16.7% vs 6.4%.),all the difference showed statistical significance.There were no statistical differences between CT and MRI in the evaluation of involvement of nasal cavity(28.2% vs 21.8%),post-styloid space(65.4% vs 67.9%),pharynx cavity(2.6% vs 1.3%) and cervical lymph node metastasis.According to MRI data,42.3% of T classification,25.6% of N classification,and 28.2% of clinical stages were changed compared to CT scan.Conclusions:There is remarkable advantage of MRI in the detection of infiltration of NPC,especially in the base of skull,cavernous sinus,and retropharyngeal lymphatic metastasis.The '92 stage system should be changed to adapt MRI information into clinical stage and it might impact on the prognosis of NPC.

Objective To study the pathogenesis of pathogens of sexually transmitted disease (STD) in acute pelvic inflammatory disease (PID) Methods Neisseria gonorrhoeae, chlamydia trchomatis, ureaplasma urealyticum were cutured respectively in 130 patients with acute PID Results The pathogens of STD had been found in 55 patients The detective rate of Neisseria gonorrhoeae was 6 9% (9/130), about half of them were mixed infection; the detective rate of chlamydia trachomatis was 4 6% (6/130), all of them were mixed infection; the positive percentage of ureaplasma urealyticum was 37 7% (49/130), one third of them were mixed infection Conclusion The pathogens of STD might cause acute PID or only play a synergetic role in it

Objective To investigate and compare relative blood volume (RBV) changes in dialysis-symptomatic hypotension and dialysis-refractory hypertension during hemodialysis. Methods Fifteen patients with dialysis-symptomatic hypotension (SH group) and thirteen patients with dialysis refractory hypertension (RH group) on chronic haemodialysis were enrolled in this study. RBV, blood pressure, heart rate and ultrafiltration volume (UV) were measured before hemodialysis and at 1 hour intervals during hemodialysis. Total of 149 and 146 five-hour hemodialysis sessions were performed separately. RBV was assessed using Automatic Blood Volume Monitor. Results RBV changes were significantly higher in SH group than in RH group (P

Objective To investigate the expression and effects of endothelin-1 (ET-1) in cerebral vessels of scalded rats. MethodHistological method was used to observe the alteration of histological structure of basilar artery in 8 scalded rats. Reverse transcription polymerase chain reaction(RT-PCR) was performed to examine expression of ET-1 mRNA;Western blotting to analyse expression of endothelin-1;radioimmunoassay to measure ET-1 levels;R3espectively, of cerebral basilar artery in 48 scalded rats. ResultVascular pathohistological changes were observed in cerebral basilar artery after rats were scalded;ET-1, ET-1 mRNA expression and ET-1 levels of basilar artery in scald 6 hours, 12 hours and 24 hours group were obviously higher than that of control group. Conclusion Scald may cause an increases of ET-1 expression in basilar artery, and elevated ET-1 expression may relate to the pathogenesis of cerebral vascular injury in scalded rats.

BACKGROUND:Elderly patients with hip surgery in the department of orthopedics are often associated with a variety of diseases, and easily suffer from complications after implantation.
OBJECTIVE:To analyze the characteristics and the factors of complications and mortality of the elderly patients with hip disease by different orthopedic implants.
METHODS:249 patients accepted total hip arthroplasty, femoral head replacement, proximal femoral nail, Gamma nail, and holow screw fixation. We analyzed patients’ age, sex, hip disease type, anesthesia risk assessment, psychological and psychiatric factors, admission hemoglobin, preoperative albumin, Charlson comorbidity index, ways of anesthesia, orthopedic implants, operation time, intraoperative bleeding, length of stay, postoperative complications, mortality and survival.
RESULTS AND CONCLUSION:Hip disease in the elderly was repaired with five kinds of implants. (1) There were significant differences in age, anesthesia risk assessment, hemoglobin on admission and preoperative albumin, length of stay, duration and intraoperative bleeding. No significant difference in complications and death was found. (2) The most significant indicators affecting complications were length of stay and albumin on admission and preoperative Charlson comorbidity index. The most significant
indicators affecting death were age and hemoglobin on admission and preoperative Charlson comorbidity index. (3) Significance of comprehensive assessment of patients before placement: during hip operation, implants were not the factors that affected the complications and mortality after placement, patients with artificial joint replacement could get out of bed early, and complications and mortality could be reduced. Elderly patients with anemia, hypoalbuminemia and Charlson comorbidity index≥3 should be given a high degree of attention. We should assess Charlson comorbidity index as early as possible, positively treat complications, correct anemia and hypoproteinemia, prevent the occurrence of complications, shorten the length of hospital stay, and reduce the mortality after placement.

BACKGROUND:Chronic tendinopathy is a tendon disorder extremely common in athletes and in the general population with repetitive strain injuries of tendons. The pathogenesis of tendinopathy remains unclear and hence treatment of tendinopathy is usual y pal iative.
OBJECTIVE:To investigate the of adipogenic and tenogenic ability of patel ar tendon-derived stem cel s isolated
from chronic tendinopathy and healthy rats in vitro.
METHODS:Tendon-derived stem cel s were isolated from patel ar tendons of chronic tendinopathy and healthy rats respectively. The tendon-derived stem cel s were cultured to the 3rd passage in complete culture medium, and cel morphology was observed. The cel s were divided into adipogenic induction group and control group. Cel s in the adipogenic induction group were cultured in adipogenic induction medium, while those in the control group cultured in complete culture medium. The ability of adipogenic differentiation between tendon-derived stem cel s isolated from the tendon of chronic tendinopathy and healthy rats in vitro was examined by oil red O staining and quantification assay. The mRNA expressions of C/EBPαand PPARγ2 were detected by real-time quantitative PCR. When 70%-80%cel s were confluent, the mRNA expressions of Col1a1, Scx, Tnmd and Dcn were also detected by real-time quantitative PCR.
RESULTS AND CONCLUSION:At the third passage, slender spindle-shaped cel s were seen in both two groups, but there was a little change in the cel morphology in the chronic tendinopathy group. Lipid droplets were formed after the cel s were cultured in adipogenic induction medium for 21 days. This was not observed in the control group. We observed more oil red O-positive oil droplets in tendon-derived stem cel s from the tendons of chronic tendinopathy rats than healthy rats. The difference between them was statistical y significant (P=0.004). The results of real-time quantitative PCR showed that the mRNA expressions of C/EBPαand PPARγ2 in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly higher than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.004);the mRNA expressions of Col1a1, Scx, Tnmd and Dcn in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly lower than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.009). In conclusion, tendon-derived stem cel s from chronic tendinopathy rats showed a higher ability of adipogenic differentiation, but a lower capacity of tenogenic differentiation compared to tendon-derived stem cel s from healthy rats, which might contribute to better understand the pathogenesis of tendinopathy.

BACKGROUND:Mesenchymal stem cells are commonly used in tissue engineering, while whether
synovium-derived mesenchymal stem cells from human knee joints can make a role in repair and regeneration of bone tissue as the appropriate seed cells need to be further verified.
OBJECTIVE:To study the osteogenic differentiation potential of synovium-derived mesenchymal stem cells which were harvested from human knee joint with end-stage osteoarthritis in vitro. Meanwhile, to identify the osteogenic characteristics of these induced synovium-derived mesenchymal stem cells.
METHODS:cellpopulations were enzymatical y released from the synovial membrane obtained from total knee arthroplasty. Nucleated cells were plated at an appropriate density (200 cells/cm2) for expansion at the maximum rate without colony-to-colony contact. Monoclone was obtained by selecting as primary synovium-derived mesenchymal stem cells. After primary cultured in control medium and expanded to three passages, synovium-derived mesenchymal stem cells were subjected to in vitro assays to investigate their osteogenesis potential in osteogenic medium containing dexamethasone,β-glycerophosphate and ascorbic acid.
RESULTS AND CONCLUSION:Nucleated cells from the synovial membrane formed single cel-derived colonies, which were of polygon shape and star shape, uniform in size. After three passages, homogeneous populations of fibroblast-like cells were observed. Under appropriate culture conditions, synovium-derived mesenchymal stem cells were induced to differentiate to the osteocyte lineages which had typical“slabstone”appearance of osteoblasts. Osteogenesis was stained positively for alkaline phosphatase staining at day 7 and formed mineralized nodular structures at day 21, which was confirmed by Alizarin red staining. Alkaline phosphatase activity assay showed a rise after the osteogenesis induction and reached the peak at day 7. Expressions of osteocyte specific genes, such as col agen type Ⅰ, Runx2, bone-binding protein and osteopontin, were al detected. These genes were expressed positively in osteogenic medium, and the mRNA expressions of col agen type Ⅰ, Runx2, bone-binding protein and osteopontin were enhanced significantly after 21 days. Our study demonstrates that synovium-derived mesenchymal stem cells isolated from knee joint of end-stage osteoarthritis patients could be induced into osteoblasts in vitro, and these induced cells have typical osteogenesis characteristics. Synovium-derived mesenchymal stem cells may play a role in the regenerative response during the process of bone injury, which are promising candidates for bone tissue engineering.

Objective To investigate the current status about the application of alteplase (rt-PA) for intravenous thrombolysis in acute ischemic stroke patients,and clarify the relevant factors affecting patients'compliance of intravenous thrombolysis.Methods The acute ischemic stroke patients admitted in Department of Emergency,from January 2014 to December 2015 were recruited for study prospectively.After the patients with contraindications of thrombolysis were excluded,the eligible patients were divided into two groups,intravenous thrombolysis group (ITG) and non-intravenous thrombolysis group (NTG).Receiver operating characteristic curve (ROC) was used to determine the optimal cutoff point and the crucial NIHSS score of patients for decision on thrombolysis therapy.Results There were 230 patients with acute ischemic stroke occurred in the period of two years.Of 189 eligible patients,33 refused the intravenous thrombolysis treatment (NTG) whereas 156 willing to take the intravenous thrombolysis treatment (ITG).The intravenous thrombolysis rate of eligible ischemic stroke patients reached to Henan Provincial People's Hospital within the time window (4.5 hours) was 67.8％ without contraindications.The results of the single-factor analysis for the patients of the two groups displayed that the differences in factors including age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness were significant between two groups (t =2.578,P =0.047;U =157.221,P =0.000;x2 =26.702,P =0.000;x2=9.069,P =0.003;x2 =7.381,P =0.007;x2 =28.636,P =0.000).The ROC analysis demonstrated the relationship between the baseline NIHSS score and the patients receiving intravenous thrombolysis.When NIHSS score ＜ 7,patients tended to refuse the treatment with intravenous thrombolysis (sensitivity 0.87,specificity 0.82).Among the patients receiving intravenous thrombolysis,the significant differences in intracranial hemorrhage rate,hospitalization mortality rate and 3-month mortality rate were not found between the patients with baseline NIHSS score≥7 and score ＜7 (1.9％ vs.3.9％,P =0.662;1.9％ vs.7.8％,P =0.168 and 3.8％ vs.11.7％,P =0.142,respectively).However a higher rate of favorable prognosis (3-month modified Rankin Scale score ≤ 1) was observed in thrombolysis patients (75.5％ vs.41.7％,P =0.000).Conclusions Factors such as age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness are supposed to be associated with patients' compliance of intravenous thrombolysis.

Objective To explore the association between body mass index(BMI)/waist circumference (WC)and blood triglyceride(TG)level in adults. To evaluate the value of the BMI and WC in diagnosing the hypertriglyceridemia by the receiver operating characteristic(ROC)curve.Methods A total of 1 093 adults(707men and 356 women)were examined in our hospital from July to September in 2008.Height,weight,WC and blood triglyceride were measured and analyzed.The ROC curve was drawn to evaluate the sensitivity and specificity of the threshold values.Results The hypertriglyceridemia rate was 33.5%among men and 8.3%among women.The BMI and WC of hypertriglyceridemia group were significantly higher than those of normal TG group for both men and women(P<0.01).The area under ROC curve was 0.728±0.041 for men and 0.708±0.021 for women when using BMI to predict hypertriglyceridemia.The optimal threshold value was 24.5 for men and 22.5 for women.The area under ROC curve was 0.790±0.042 for men and 0.714±0.020 for women when using WC to predict hypertriglyceridemia.The optimal threshold value was 86 cm for men and 77 cm for women.Conclusions Both BMI and WC are associated blood triglyceride level. WC and BMI are useful parameters in predicting hypertriglyceridemia.

Objective To investigate the clinical characteristics of twice-weekly hemodialysis patients.Methods Data were collected from Shanghai Renal Registry.A total of 1288 patients undergoing regular hemodialysis (HD) with dialysis adequacy index and other biochemical parameters in Shanghai in January 2007 were enrolled into the cohort study with 2 years follow-up.Clinical characteristics and outcome of twice-weekly HD patients were analyzed as compared with thrice-weekly HD patients.Results Compared with patients on thrice-weekly HD,the twice-weekly HD patients were significantly younger and had significantly shorter HD vintage,smaller body surface area,longer HD session time,higher single-pool Kt/V (spKt/V) and serum albumin but lower weekly Kt/V (P＜0.05).There was no statistical difference in ultrafiltration volume between two groups.Kaplan-Meier survival analysis indicated that both groups had similar two-year survival.Multivariate Cox regression analysis showed that age,body mass index,serum albumin and weekly Kt/V were predictors of patient mortality.Conclusion It is acceptable for some hemodialys patients with twice-weekly HD,and close monitor of dialysis adequacy and volume status is necessary for this therapy model.