The nutritional support has become an important part of the management of pa- tients with severe head injury.Fifty- two cases were supported by early nutritional supplement.The result showed that themortality and morbidity were decreased.It is experienced that early nutritional support may reduce the loss of body protein and vis- ceral proteins,increase the function of cellu- lar immune system and promote the recov- ery of impaired nerves.

Problems in metrology work in special hospital are elaborated,such as poor law awareness,repeated break-down of metrology equipment,etc.Improvement suggestions are put forward including emphasis on well-constituted metrology staff and adequate equipment purchase,cooperation in clinical departments,strengthening the management of metrology equipment at all levels,reinforcing the work function of the leading group in metrology management.This study is significant in supporting medical treatment and enhancing the hospital medical quality.

Objective To study the clinical characteristics of neonatal pertussis.Method From January 2011 to December 2015,clinical data of newborns with pertussis treated in our hospital were retrospectively analyzed,including the general information,clinical manifestations,laboratory examinations,treatment and prognosis.Result A total of 68 newborns with pertussis were found during the study period,including 1 case in 2011,5 cases in 2012,1 case in 2013,18 cases in 2014 and 43 cases in 2015.The time needed for diagnosis was 7 to 35 days after onset of symptoms,and 80.9％ (55/68) in 14 days.The predominant manifestation was paroxysmal cough (68 cases,100％).Other common symptoms included flushing in 45 cases (66.2％) and cyanosis with coughing in 40 cases (58.8％).The uncommon symptoms included whooping cough (20 cases,29.4％),wheezing (10 cases,14.7％),fever (3 cases,4.4％) and apnea with decreased heart rate during cough (2 cases,2.9％).12 patients (17.6％) had elevated peripheral white blood cells or lymphocytes.The clinical manifestations didn't disappear despite erythromycin therapy,and the whooping cough continued for 12 to 42 days during the course of disease.22 cases (32.4％) had complications,including pneumonia in 12 cases,myocardial damage in 10 cases,heart failure in 2 cases,respiratory failure in 1 case,atrial tachycardia in 1 case and lung consolidation in 1 case.Conclusion Neonatal pertussis is not uncommon and has a tendency to increase year by year,and it's challenging for early diagnosis.The patients who have a whooping cough without fever should be considered of pertussis until otherwise ruled out.Leukocyte and lymphocyte count are of little value in the diagnosis of this disease.

Maxillary sinusitis is a common condition in nose section. Traditional operations are always have more complications and easy to relapse, seriously affectting the quality of patient's life. The application of functional endoscopic sinus surgery (FESS) makes a qualitative progress on surgical treatment of maxillary sinusitis. In re- cent years, the researchs found that there are still unsatisfactories to long-term curative effect of some patients With the development of minimally invasive, people begin doubting its "functional". Recently, some new treat- merits have emerged in the world, but their safety and effectiveness needs further research. To seek for a better treatment, this article reviews the development and the existential problems of maxillary sinusitis surgery.
Endoscopy ; Humans ; Maxillary Sinusitis ; surgery ; Nose ; physiopathology ; surgery ; Recurrence

To obtain an ideal recombinant C-terminal fragment of the merozoite surface protein of Plasmodium falciparum in the Pichia pastoris expression system, the major surface protein-119 (MSP-119) gene sequence bearing the 6-his gene was inserted into expression vector pPIC9k and the target gene was transformed to the susceptible yeast cells GS115 by using electroporation. The multiple inserts were screened and the successfully expressed MSP-119 protein with the relative molecular weight of 12kDa in the supernatants of cell cultures could be detected by SDS-PAGE. Meanwhile, Western blot analysis also demonstrated that this protein reacted with mouse anti-MSP-119 monoclonal antibody, and the expression level of MSP-119 was more than 1.0 g/L. It is concluded that this recombinant protein expressed in the Pichia pastoris expression system resembles the native proteins existed.

Objective To evaluate the effects of valsartan and angiotensin-converting enzyme inhibitors on the excretion rate of urinary albumm(UAER) and the clearance of endogenous creatinine(Cr-C) in elderly patients.Methods 120 elderly patients with stage of the 2～3 class hypertension were included.The patients were divided into 3 groups,the valsartan group and the benazpril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment.Results No significantly different anti-hypertensive effects were observed in valsartan,benazpril and captopril.But the effects of UAER,Cr-C in valsartan group had significant changes compared with the other groups,and the three groups had significant differentiation(P

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.

Objective To understand the clinical characters and imaging features of Mirizzi syndrome.Methods All 15 patients were confirmed by operation , including 10 females and 5 males , aged 41～82 (mean age 65.1 years old). The course ranged from 4 days to 15 years. Among them, ERCP were performed in 8 patients, PTC in 2 patients, MRCP in 4 patients and CT in 3 patients.Results Cholangiography of Mirizzi syndrome revealed a broad, curvilinear impression on the common hepatic duct in the area where the cystic duct or gallbladder was in direct apposition, hepatic bile duct dilation above the level of the cystic duct. 6 cases were diagnosed to be Mirizzi syndrome preoperatively (3 cases in ERCP , 2 cases in PTC , 1 case in MRCP), 7 cases bile duct stone, 1 case bile duct dilation, 1 case normal. Conclusion Mirizzi syndrome is a rare disease . No pathognomonic features appear in either the history or the physical examination .Diagnosis requires a combination of ultrasonography , cholangiography (ERCP,PTC), CT and MRI .

Objective To evaluate the clinical value of low field strength MRI in judging the invasion of myometrium of endometrial carcinoma in staging Ⅰ.Methods 32 cases with endometrial carcinoma approved to be clinical staging Ⅰ pathologically were evaluated by MRI before operation.The staging results of MRI were compared with pathologic results and analysed with statistic methods.Results According to 1988 FIGO staging the staging of the lesions was further carried out,including stage Ⅰa in 6,stage Ⅰb in 18 and stage Ⅰc in 8 cases.Compared with pathologic results,the sensitivity and specificity of MR in evaluating myometium invasion were 92% and 83% respectively,the staging accurate rate was 78%.Conclusion The endometrial carcinoma stage Ⅰ can be staged further by low field strength MRI,MRI has significant advantage in estimating the invasion of myometrium.

Objective To investigate the clinical significance of expression of P53,Ki67 in proliferation,invasion and metastasis of cancer cells of patients with esophageal carcinoma.Methods Eighty-six patients with esophageal carcinoma were selected as tumor group from January 2006 to May 2008.And another 86 patients without tumor were as control group.ABC-immunohistochemistry was used to detect the expression of P53 and Ki67 in 172 cases of patients with esophageal carcinoma.Results The expression of P53 in patients with esophageal carcinoma was different from that in control subjects (x2 =4.045,P ＜ 0.05),and the P53 expression rate in two group were 66.3％ (57/86) and 51.1％ (44/86) respectively.The rate of P53 expression reaching to + + in two groups was also significant (x2 =8.592,P ＜ 0.01).Ki67 expression in patients with esophageal carcinoma was higher than that of control patients (76.7％ (66/86) vs.60.5％ (82/86),x2 =5.291,P ＜ 0.05).Additionally,there was significant difference regarding of Ki6 expression reaching to + + positive(x2 =13.661,P ＜ 0.01).Moreover,the expression of P53 and Ki67 were found to be a positively correlation(r =0.400,P =0.00).The expression of P53 and Ki67 were related with invasion and differentiation of cancer cells (x2 =3.945,5.794 respectively,all P ＜ 0.05) and lymph node metastasis (x2 =5.570,4.354 respectively,all P ＜ 0.05).Conclusion Over-expression of P53 and Ki67 were involved in the process of proliferation,invasion and metastasis of cancer cells in esophageal carcinoma,which coherently impacted the occurrence and development of esophageal cancer.The combined detection of P53 and Ki67 seems to help the early diagnosis of esophageal cancer and evaluation of the degree of malignancy,invasion,metastasis and prognosis.Over-expression of P53,Ki67 might be served as a reference marker in screening for chemotherapy for esophageal cancer.