OBJECTIVE: To investigate the difference of the symptoms evaluation between CRS patients and doctors. METHOD: Seven symptoms including nasal obstruction, watery rhinorrhea, sneezing, rhinocnesmus, itching of eyes, hyposmia and facial pain were evaluated by visual analog scales (VAS) by the patients. The assigned rhinologist finished VAS evaluation of doctor based on the patient's description of their symptoms. Rank test was used to analyze the difference for each VAS scores of symptom between patients and doctor. Spearman test was used to analyze the effect of age in VAS scores and the effect of gender was analyzed by using Mann-Whitney test. RESULT: We found that the sum and every single patient's nasal symptoms VAS scores both showed statistical significantly difference (t = 4.51 P < 0.01). VAS scores of nasal blockage showed the significant difference between patients and doctor (r = 359.52 P < 0.01). Age of patients did not show correlation with VAS scores (r = -0.074 P > 0.05) also, gender of patients didn't show statistical significant (P > 0.05). CONCLUSION There were differences between patient's and doctor's nasal symptoms VAS scores and the VAS scores of patients were higher than the doctor's. Age and gender of patient were not related to the VAS evaluation.
Chronic Disease ; Humans ; Observer Variation ; Patients ; Physicians ; Rhinitis ; diagnosis ; Sinusitis ; diagnosis ; Visual Analog Scale

Objective To elucidate the relationship between Ca2+/calmodulin-dependent protein kinaseⅡ(CaMKⅡ)and autophagy during the development of cardiac hypertrophy. Methods Rat embryonic cardiac cell line H9c2 cells was treated by angiotensin Ⅱ to establish cardiomyocyte hypertrophy model in vitro and using antagonists and gene function gain and loss to analyze AMPK-LC3Ⅱ autophagy signaling pathway. Results The phosphorylation of CaMKⅡ and autophagy related signaling-AMPK and autophagy marker LC3Ⅱ were rapidly increased by angiotensinⅡtreatment at early stage. However ,the above changes were highly blocked by CaMKⅡinhibitor and HDAC4 inhibition. Conclusion CaMKⅡ is the center factor of regulating cardiac hypertrophy ,it mediates autophagy through directly regulating AMPK or indirectly regulating HDAC4 during the development of cardiac hypertrophy.

Objective To analyze the positive rate of autoantibodies in Xinjiang Uygur patients with different types of auto‐immune liver disease and its diagnostic value .Methods Fifty‐one Uygur outpatients and inpatients with of autoimmune liver disease in our hospital from October 2012 to October 2014 were selected ,including 20 cases of autoimmune hepatitis (AIH ,AIH group) and 31 cases of primary biliary cirrhosis (PBC ,PBC group) .The indirect immunofluorescence and Western blotting were used to detect the serum biochemical indexes and autoantobodies ,and the comparative analysis was performed .Results The levels of various bio‐chemical indexes in the two groups were increased ,in which ALT ,γ‐GT ,ALP and IgM levels had statistical difference between the two groups(P<0 .05) .The positive rates of ANA ,SMA ,LKM‐1 antibody ,LC‐1 antibody ,SDLA/LP antibody and AMA in the AIH group were 65 .0% ,40 .0% ,10 .0% ,5 .0% ,10 .0% and 5 .0% respectively ;the positive rates of ANA ,AMA and M2 subtype (AMA‐M2) in the PBC group were 61 .3% ,100 .0% and 96 .8% respectively .Conclusion The autoantibodies spectrum in Xinjiang Uygur patients with autoimmune liver diseases has certain characteristics .The autoantibodies spectrum detection has an important significance for the diagnosis ,classification and differential diagnosis of autoimmune liver diseases .

Objective To identify the availability of video-assisted thoracoscopic thymectomy. Methods Retrospectively analyzed 68 patients with myasthenia gravis who underwent thymectomy including 34 cases of video-assisted thoracoscopic thymectomy and 34 cases of transsternal thymectomy,and the patients were followed up for 16 years. Results Patients of the VATS group were given video-assisted thora-coscopic thymectomy. The mean operative time was (90. 1 ± 15. 0) min,mean blood loss was (45. 0 ± 5. 5) mL,mean chest tube drainage time was (2. 5 ± 1. 2) days and mean postoperative hospital stay was (7. 0 ± 1. 2) days in VATS group,and there was no serious complica-tions and surgical death. The mean operative time was (98. 0 ± 12. 5) min,mean blood loss was (118. 5 ± 17. 5) mL,mean chest tube drain-age time was (4. 5 ± 1. 3) days and mean postoperative hospital stay was (11. 0 ± 2. 5) days in transsternal thymectomy group. 3 patients de-veloped MG crisis. There was no significant difference in mid-and long-term effects between the two groups(P>0. 05). ConclusionVideo-as-sisted thoracoscopic thymectomy for MG is safe and feasible with the advantage of less invasion,less surgical trauma,lower rate of complica-tion,and good curative effect compared with transsternal thymectomy.

Objective:To investigate the expression and role of costimulatory molecule CD137 on CD4+T cell in patients with systemic lupus erythematosus(SLE).Methods:The expression of CD137 on T lymphocyte from 30 SLE patients and 20 healthy controls were detected by flow cytometry.Results:The expression of CD137 on CD4+T lymphocytes from patients with active SLE were significantly higher than that of patients with inactive SLE and normal control(21.56?4.08 vs 3.01?0.09,1.24?0.12,P

Objective To investigate the correlation of serum concentrations of interleukin(IL)-6,IL-10 and tumor necrosis factor(TNF)-α and the prognosis of sepsis in children.Methods Fifty-seven septic patients in PICU were enrolled in the study,of whom 44 patients survived(sepsis survival group),13 patients died(sepsis dead group).Another 65 cases of non-sepsis patients served as control(non-sepsis group).The critical illness score,the number of damaged organs,and serum levels of IL-6,IL-10,TNF-α,IL-6/IL-10,TNF-α/IL-10 in each group were compared.Results The critical illness score was decreased and the number of damaged organs was more in sepsis dead group than those in non-sepsis group and sepsis survival group.Compared with non-sepsis group and sepsis survival group,the expression of IL-6 and IL-10 increased,TFN-α/IL-10 ratio significantly decreased in sepsis dead group(P ＜ 0.05),but the difference between the sepsis survival group and non-sepsis group was not statistically significant(P ＞ 0.05).The serum levels of TNF-α and IL-6/IL-10 ratio showed no significant difference among three groups(P ＞ 0.05).Conclusion In sepsis patients,the serum concentrations of IL-6,IL-10 are higher and the TNF-α/IL-10 ratio is smaller,the prognosis is worse.

BACKGROUND: Cerebral vascular spasm is the main complication of intracranial aneurysm during perioperative period. Anesthesia of clamp operation of intracranial aneurysm not only meet the basic requirement of anesthesia, but also prevent cerebral vascular spasm and protect cerebral function possibly.OBJECTIVE: To observe the changes of angiotensin Ⅱ and endothelins of paitents with intracranial aneurysm under the anesthesia of desflurane during the clamp operation so as to discuss the effect of desflurane on cerebral protection.DESIGN: Case analysis.SETTING: Department of Neurosurgery and Department of Anesthesiology of Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences.PARTICIPANTS: Totally 64 patients, 30 males and 34 females, who were prepared for clamp operation of intracranial aneurysm, were selected from Department of Neurosurgery of Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences between October 2002 and June 2004.METHODS: After anesthesia induction, tracheal cannula was used to control respiration and desflurane was used to maintain the anesthesia. Totally 4 mL arterial blood were collected at the four time points: before anesthesia induction, cutting dura mater, clamp aneurysm and 30 minutes after clamp aneurysm. Levels of angiotensin Ⅱ and endothelins in plasma were assayed with radioimmunoassay.MAIN OUTCOME MEASURES: Levels of angiotensin Ⅱ and endothelins at the four time points: before anesthesia induction, cutting dura mater,clamp aneurysm and 30 minutes after clamp aneurysm.RESULTS: Aneurysm of two patients was disrupted during the operation of angiotensin Ⅱ was ranged normally before operation, and that at the other three time points during the anesthesia of desflurane did not changed endothelins: Level of endothelins at the three time points of cutting dura mater, clamp aneurysm and 30-minutes after clamp aneurysm was lower than that at the time point of pre-an esthesia induction [(40.4±10.3),(40.0±9.6), (40.7±12.3), (49.3±12.7) ng/L, (P=0.002, 0.001, 0.009)].CONCLUSION: Levels of angiotensin Ⅱ and endothelins which anesthetizes by desflurane are not increased during the whole clamp operation of intracranial aneurysm. However, level of endothelins is obviously lower than that at the time point of pre-anesthesia induction, and there is not significantly different from that at various time points of the operation. This suggests that anesthesia of desflurane can avoid the onset of acute cerebral vascular spasm induced by the increasing liberation of angiotensin Ⅱ and endothelins and decrease the onset of secondary cerebral ischemic injury so as to protect brain.

BACKGROUND: Cerebral ischemia and reperfusion affects not only cellular necrosis at acute stage, but also delayed neuronal apoptosis in central neural system.OBJECTIVE: To observe apoptosis rate, necrosis rate and expression of Bcl-2 and Bax apoptpsis-regulating proteins in hippocampal neurons at various reperfusion stages of complete cerebral ischemia in rats so as to probe into the regulation of injury induced by complete cerebral ischemia and reperfusion.DESIGN: Randomized control experiment.SETTING: Department of Neurosurgery and Department of Anesthesiology in Beijing Tiantan Hospital Affiliated to Capital University of Medical Sciences.MATERIALS: The experiment was performed in Beijing Institute of Neurosurgery Affiliated to Capital University of Medical Sciences from January 2003 to January 2004. Totally 33 healthy adult male Wistar rats of clean grade were employed, randomized in 5 groups, named ischemia +reperfusion 24 hours group (24 hours group) (7 rats), ischemia + reperfusion 48 hours group (48 hours group) (7 rats), ischemia + reperfusion 72hours group (72 hours group) (7 rats), ischemia + reperfusion 7 days group (7 days group) (7 rats) and sham-operation control (control) (5 rats).INTERVENTIONS: Model of complete cerebral ischemia and reperfusion was prepared in rat. Cerebral hippocampal tissues were collected in 24, 48,72 hours and 7 days after reperfusion successively. The flow cytometer was used to determine cellular apoptosis rate and necrosis rate and expression of Bcl-2 and Bax proteins in cerebral hippocampal neurons in rats.percentages of Bcl-2 and Bax proteins.hippocampal neurons in 7 days group was the highest [(24.59±0.97) %].The peak value of necrosis rate presented in 24 hours group [(16.67±1.04)%], which was remarkably higher than the control [(1.28±0.50)%,low [(1.07±0.27)%], but high expression of Bax presented [(46.09±5.37)%].and reperfusion [(14.41±0.67)%] and the peak value of Bax protein presented in 72 hours after ischemia and reperfusion [(77.38±1.52)%].CONCLUSION: Hippocampal neuronal apoptosis rate is increased gradually and expression of Bcl-2 and Bax apoptosis-regulating genes was increased abnormally after injury induced by complete cerebral ischemia and reperfusion, which suggests that Bcl-1 and Bax proteins are involved in apoptosis regulation in the injury induced by complete cerebral ischemia and reperfusion.

Objective To investigate the surgical techniques of the modified presigmoid trans-partial bony labyrinth approach and the advantages in exposure of the petroclival region and in treat the lesion of this area.Methods By simulate the modified presigmoid trans-partial bony labyrinth approach in 15 adult cadaveric heads with the aid of an operating microscope and record important structures in the petroclival region.Results The petroclival region,the posterior cavernous sinus,Meckel cave,the vertebral-basilar artery,the anterior inferior cerebellar artery,the superior cerebellar artery,ipsilateral Ⅲ-Ⅹ cranial nerve nere fully exposured and contralateral Ⅵ cranial nerve were fully exposured.The range of presigmoid exposure was (19.41 ± 1.58)mm,the exposurein of inferior temporal was (14.18 ± 1.88) nun,the maximum exposure angle of slope center depression was (60.54 ± 6.93) °,the depth of operation was (55.87 ± 4.34) mm.Conclusion The advantages of the modified presigmoid trans-partial bony labyrinth approach can earn enough exposures of deep part of petroclival region and posterior part of cavernous sinus,improved petroclival exposure,multiple axes of visualization,preservation of hearing and facial nerve function,and early devascularization of the tumor.

Objective To investigate spinemagnetic resonance imaging(MRI) findings in patients with axial spondyloarthritis (SpA) and to analyze the correlation between imaging and clinical manifestation.Methods The clinical data of patients with axial SpA were recorded.All patients underwent whole spine MRI scanning.The MRI findings of spinal involvement were explored.Moreover,the correlation between lesions in spinal MRI and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI),Bath Ankylosing Spondylitis Metrology Index (BASMI),nocturnal pain visual analogue scale (VAS) score,back pain VAS score,global disease activity VAS score,Ankylosing Spondylitis Disease Activity score (ASDAS),erythrocyte sedimentation rate,C-reactive protein was analyzed.Results Thirty-three patients with axial SpA were included in this study.The image abnormalities of the spine were confirmed in 29 axial SpA patients by MRI,including Romanus lesion,Andersson lesion,the inflammation of facet joints and syndesmophyte.In correlation study,BASMI was positively correlated to the numbers of acute Romanus lesions,chronic Romanus lesions,chronic Andersson lesions and whole spinal lesions(r =0.440,P＜0.05; r =0.483,P＜0.05; r=0.421,P＜0.05; r=0.589,P ＜ 0.05 respectively).There was a statistically significant correlation between chronic Andersson lesions and BASFI(r =0.392,P ＜0.05).But no significant associations were found between MRI lesions and other clinical findings.Conclusions MRI lesions in axial SpA were associated with findings reflecting the spinal function,which can better guide the clinical treatment.