Objective This thesis observes the effect of integrated traditional Chinese and western medical nursing on the therapeutic effects of chronic sinusitis with nasal endoscopic surgery.Methods 106 patients with chronic sinusitis were randomly recruited into an observation group and a control group.The observation group was treated with traditional Chinese medicinal syndrome differentiation care besides conventional western medical care to observe the effectiveness.Resulls The therapeutic effectiveness and the degree of satisfaction about health education in the observation group was significant better than the control group(P＜0.05).Conclusion Integrated traditional Chinese and western medical care could improve the degree of satisfaction on patients with Chronic sinusitis and promote patients recovery from illness.

Objective To establish a method for the determination of aristolochic acid A inPaishi granule.Methods The HPLC system consisted of the Phenomenex Luna C18(4.6 mm×250 mm, 5μm)column, the mobile phase consisted of acetonitrile and 0.01% HAc, gradient elution flow rate was 1.0 ml/min, the column temperature was 35℃, The UV detector was set at 250 nm.Results The linear response range was 0.029-0.580μg/ml (r=0.999 9). The detection limit and quantitation limit of aristolochic acid A inPaishi granule were 0.9 and 3.0 ng/ml. The average recovery of aristolochic acid A was 96.4%.Conclusion The method is high sensitivity, accurate, repeatable and high specificity,and can be used as an inspection method for safe use of Paishi granule.

Objective To explore the association of methyl-CpG-binding protein2 (MeCP2) polymorphisms with female schizophrenia in Chinese Han population.Methods By using the technology based on microarray Chip,gene polymorphism analysis of 4 locus located in the gene MeCP2 was performed in 126 schizophrenia patients fulfilled with DSM-Ⅳ-TR criteria for schizophrenia and in 144 healthy controls.Chi square test was used to compare the inter-group differences of genotypic and allelic distribution.Haplotype case-control association analysis based on linkage disequilibrium was conducted using SNP stats online software after the data was screened.The significance of results was corrected by permutation test.Results To the point of Locus rs1616369 which located in Gene MeCP2,the distribution of the genotype G/A between two groups(24.8％ vs 34.3％) reached significance (P＜0.05) ; rs3027933,genotype G/C(25.6％ vs 34.8％),P＜0.05 ; rs17435,genotype T/A(25.6％ vs 35.5％),P ＜ 0.05 ; rs2239464,genotype C/A (58.5％ vs 71.8％),P＜ 0.05.The distribution prevalence of Haplotype GCCA was 0.1581 in case group,and 0.2389 in control group,reached significant difference(P＜0.05).Conclusion As to female MeCP2 gene,the genotype on the four locations might associate with the onset of schizophrenia,MeCP2 might be susceptibility gene of female schizophrenia.The Haplotype GCCA maybe the protective factor.

Objective To introduce the application and assess the outcome of ProPlan CMF software in virtual surgery of mandibular resection and reconstruction with vascularized fibular graft.Methods Nineteen patients were performed mandibular resection,and immediate reconstruction with free fibular graft by application of ProPlan CMF software between March 1,2013 and January 31,2014,including 7 cases of osteoradionecrosis,6 cases of adamantoblastoma,4 cases of carcinoma of gingiva,2 cases of intra-osseous carcinoma of mandible.There were 12 males and 7 females,with an age range of 21-73 years (median,54 years).In each case,three-dimensional spiral CT scan of mandible and fibula was obtained before operation.The CT data were imported into the ProPlan CMF software and the virtual surgical planning was performed.After that,the mandibular rapid prototyping and surgical guide plates were made according to customized design.The segmental resection of mandible,titanium plate bending,fibular molding,insetting and fixing were then carried out by using these surgical guide plates.Results Operations were undertaken successfully according to preoperative design in all nineteen patients and negative margin was detected by intraoperative frozen section.The fibula was cut,shaped and fixed accurately.The operations took 4.5-7.0 hours (mean,5.5 hours).Primary healing of incision was obtained without complications except fistula in 2 cases of osteoradionecrosis,which were resolved with local wound care after 4 weeks.19 patients were followed up between 3 months to 1 year and all patients were alive with disease free.All patients were satisfactory with their maxillofacial appearance,occlusion and function.The ranges of mouth opening was 2.0-4.0 cm.The postoperative panoramic radiographs or CT scan showed perfect situation and contour of fibular graft.Healing of the donor site occurred without significant complications.All patients started early postoperative ambulation,and walked normally after 2 or 3 months.Conclusion The application of ProPlan CMF software in virtual surgical design and guide plates creation can simplify the operation,and improve the accuracy of mandibular resection and reconstruction,especially the spatial relationship of the mandible and the fibula graft.It is worth promotion widely in clinical practice.

Objective:To establish an HPLC method to simultaneously determine the content of protocatechualdehyde, rosmarinic acid and salvianolic acid A in Salvia miltiorrhiza Bunge. Methods: The chromatographic column was a Linksil-ODS ( 250 mm × 4. 6 mm,5 μm) column,the mobile phase was 1% acetic acid water solution-acetonitrile (7∶3) with the flow rate of 0. 8 ml·min-1 . The detection wavelength was 280nm , the column temperature was 30℃ and the injection volume was 20 μl. Results: The linear range of protocatechualdehyde, rosmarinicacid and salvianolic acid A was 3-300 μg·ml-1(r>0. 999 0), and the recovery was within the range of 95. 22%-99. 68% with RSD below 2% (n=5). Conclusion:The method is accurate, rapid and reproducible, and can be used to control the quality of Salvia miltiorrhiza Bunge.

OBJECTIVE To assess the treatment reliability of covered stent for carotid artery blowout after head and neck tumors resection. METHODS Five cases with postoperative rupture of carotid artery invaded by the head and neck tumor were reviewed. They presented with life threatening massive neck or oral bleedings. All of them were treated with self expanding covered stents through intervention therapy approach. RESULTS The covered stent were successfully deployed in the target arteries in all cases,the instant isolation effect was quite satisfactory. After treatment, angiography showed successful occlusion of the pseudoaneurysm, patency of carotid artery lumen, and significant improvement of clinical symptoms without neurologic dysfunction. Following up 2 to 36 months, 3 patients were alive with no disease, two patients died of recurrence. CONCLUSION For the treatment of carotid blowout, endovascular occlusion with covered stent is a minimally-invasive, safe and reliable methods.

Objective To explore the value of susceptibility weighted imaging (SWI) in the quantitative analysis of ischemia-reperfusion injury (IRI) of the rabbit kidneys . Methods Thirty New Zealand white rabbits were randomly assigned to IRI group (n=24, operation with clamping) and Sham group (n=6, operation without clamping). Left renal ischemia-reperfusion was performed by occlusion (calmping) of the left renal arterial for 60 minutes, followed by reperfusion. All the rabbits underwent MRI including T2WI and SWI before and 0.5 h, 12 h, 24 h and 48 h after the establishments of models . Three rabbits in IRI group were randomly sacrificed 0.5 h, 12 h, and 24 h after the establishment of model. The rest of the rabbits in IRI group and 6 rabbits in sham group were sacrificed for pathological examination 48 h after the establishment of model All specimen were cut into slices and stained with hematoxylin-eosin (HE). Region of interest ( ROI) was manually created by outlining the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex, then relative signal-to-noise ratio of the kidney (rSNR) to muscle in SWI sequence was recorded. and compared with histopathologic features. One-way ANOVA was performed to compare difference of rSNR to muscle in respective location at 5 time-points between Sham group and IRI group, and the differences between groups were tested using repetitive measure analysis of variance, repetitive measure analysis of variance was performed to compare difference of rSNR to muscle in respective location at respective time-points between Sham group and IRI group. Results rSNR value in the inner medulla 0.5 h, 12 h, 24 h and 48 h after the establishments of models were 0.28 ± 0.04, 0.98 ± 0.14, 0.69 ± 0.07, 0.57±0.06, 0.43±0.03, respectively (F=69.82,P<0.01), the inner stripe of outer medulla at the five time-points 0.08 ± 0.03, 0.57 ± 0.05, 0.32 ± 0.07, 0.16 ± 0.02, 0.04 ± 0.01, respectively(F=16.59,P<0.01), the outer stripe of outer medulla were 0.31 ± 0.04, 0.86 ± 0.09, 0.65 ± 0.07, 0.55 ± 0.06 0.43 ± 0.04(F=67.52,P<0.01), respectively,the cortex 0.05±0.01, 0.80±0.04, 0.68±0.07, 0.47±0.07, 0.36±0.08, respectively(F=118.96,P<0.01). The difference of the rSNR was statistically significant in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex at the five different time-points. The differences between two groups were significant (F=206.29, 14.25, 42.8, 39.12, P all<0.05). The pathological findings in Sham group included normalglomerular structure l, clear cavity of tubular, no interstitial hyperemia and edema. The pathological findings in IRI group demonstated, at 0.5 h after IRI, Bowman's capsule cavity expansion, glomerular shrinkage, swelling of renal tubular epithelial cells, vacuoles degeneration, the tube cavity expansion, interstitial edema and congestion ecta became slender, andat 12 h after IR, Bowman's capsule expansion became more obvious, foam degeneration of renal tubular epithelial cells, apoptosis, partial loss of the brush border of the proximal convoluted tubule, formation of protein cast, and a small amount of inflammatory cells appeared in the renal interstitium, swelling of endothelial cells of the vasa recta, congestion of small vessels, and at 24 and 48 h after IRI, more serious injury of renal tubular in the outer stripe of outer medulla , massive necrosis of renal tubular epithelial cells, apoptosis, parts of the renal tubular had the contour lines, and renal tubular outline, increment in inflammatory cells, red cell and protein cast. Conclusion rSNR of SWI in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex of the kidney varies with the degree of IRI over time, and is consistent with corresponding pathological feature, suggesting SWI is useful imaging tool to detect early damage of renal IRI quantitatively.

Purpose To explore the independent predictors of malignant solitary pulmonary nodule (SPN) manifesting as ground-glass nodule (GGN),and to establish a prediction model.Materials and Methods The clinical data and CT images of 362 patients (group A) with pathological-confirmed SPN appearing as GGN in Shanghai Chest Hospital Shanghai Jiaotong University from January 2014 to December 2015 were retrospectively analyzed.The independent predictors of malignant SPN were identified,and the clinical prediction model was established.Another 119 SPN patients in Affiliated Zhoushan Hospital of Wenzhou Medical University were selected as group B to verify the diagnostic efficiency of the prediction model.Results Using multivariate Logistic regression analysis,clear border (OR=6.274,P＜0.01),smooth edge (OR=0.391,P＜0.01),lobulation (OR=3.387,P＜0.01),pleural retraction sign (OR=2.430,P＜0.01),and vocule sign (OR=3.076,P＜0.01)were identified as independent predictors of malignant SPN.The area of the model under the ROC curve was 0.859 with 95％ CI (0.804-0.903).The diagnostic accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.92％,91.03％,81.97％,92.03％ and 73.53％,respectively.Conclusion In this study,the independent predictors of malignant SPN appearing as GGN were identified,and the prediction model was established.The model can accurately identify SPN and provide effective help for early diagnosis of SPN.

Objective To retrospectively study postoperative nonunion of femoral neck fractures so as to identify high risk factors for their nonunion.Methods A total of 965 patients with complete clinical data out of the 1 323 patients with femoral neck fractures treated by internal fixation with cannulated compression screws from January 2003 to January 2011 were included in the study.Logistic muhiple regression method was used to analyze five factors including patients' age,gender,injury mechanism (whether high energy injury or not),fracture type (with or without displacement) and medical comorbidities [American Society of Anesthesiologists Physical Score (ASAS) grade] and their correlation with fracture healing to investigate the high risk factors for the nonunion of femoral neck fractures.Results Quantitative assay of the factors affecting healing of femoral neck fractures was ranged as follows:medical comorbidities (ASAS grade),injury mechanism (whether high energy injury or not),fracturc type (with or without displacement),gender and age.Conclusion Age ＞ 50 years,females,displacement fracture,high energy injury,and ASAS grade above Ⅲ are high risk factors for nonunion of femoral neck fractures.

Objective To explore the value of abnormal imaging findings on susceptibility weighted imaging (SWI) in delayed graft function (DGF). Methods The conventional MRI and SWI images of 26 cases with DGF and 20 cases with normal renal function of transplanted kidneys were retrospectively analyzed. Patients with cysts and angiomyolipomas were excluded. Normal structures of transplanted kidney were identified. If lesions of abnormal signal intensity were found in the transplanted kidney, the location, border and signal intensity compared to renal cortex would be analyzed. The differences in signal intensity between the abnormal signal lesions and normal renal cortex in the same SWI layer of DGF were compared by using independent-sample t test. The differences in positive detection rate of discovering the abnormal signal lesions in DGF between conventional MRI and SWI were compared by using McNemar test. Results Of the 26 cases with DGF, one case was found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on both conventional MRI and SWI images. Ten cases were found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images only. Fifteen cases exhibited no abnormal signal lesions on both conventional MRI and SWI images. Twenty cases with normal renal function of transplanted kidney, no abnormal signal lesions were found on both conventional MRI and SWI images. The differences in signal intensity between the abnormally low signal lesions (130±20) and normal renal cortex (177±25) in the same SWI layer of 11 cases with DGF were statistically significant (t=-4.582,P<0.01). The differences in positive detection rate of discovering the abnormally low signal lesions in DGF between conventional MRI [3.8%(1/26)] and SWI [42.3% (11/26)] were statistically significant (χ2=8.100,P=0.002). Conclusions Abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images suggest the presence of DGF. Compared with conventional MRI, SWI appears to be superior in detecting the abnormally low signal lesions.