Carcinosarcoma ; Female ; Humans ; Maxillary Sinus Neoplasms ; Middle Aged

OBJECTIVE To investigate the expression of SleX and CD24 in nasal inverted papilloma and its pathologic features.METHODS HE staining were conducted to study the pathologic features in specimens of 11 cases with nasal inverted papilloma. Further,immunohistochemistry stain for SleX and CD24 were performed in total specimens.RESULTS One case(9.1%) was diagnosed as severe atypical hyperplasia but tumor cells did not invaded basal membranes.SleX staining located at cell membranes. Positive SleX staining was found in 9 specimens (81.8%) and 1 normal nasal epithelium (16.7%).CD24 staining located in cytoplasm.Positive CD24 staining was found in 8 specimens of nasal inverted papilloma (72.7%). CD24 was negative in nasal epithelial cells and only a few lymphocytes were positive.CONCLUSION Some cases of nasal inverted papilloma are diagnosed with severe atypical hyperplasia.Most of cases express CD24,so nasal inverted papilloma may be a borderline tumor.Expression of SleX and infiltration of inflammatory cells suggest that nasal inverted papilloma may be related to inflammatory reactions.

Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

Objective: To inquire into the testis gene change of mouse model with kidney-yang deficiency induced by overfatigue and excessive sexual life, the modern science mechanism of syndrome of kidney-yang deficiency and kidney controlling reproduction can be revealed on the gene level. Methods: The model of kidney-yang deficiency was established by each male mouse with six female mice keeping in the same cage, and all the male mice were forced to swim for 30-40 minutes everyday lasting for four weeks. The testis genes of mice in control group and model group were detected with Mouse OneArrayTM Whole Genome DNA microarray. The differentially expressed genes were screened under the condition of the relative fluorescence intensity ratio of the two groups ≥2 and ≤0.5 and further classified according to gene function by using Molecule Annotation System (MAS) created by CapitalBio Corp. Beijing, China. Results: The mouse model with kidney-yang deficiency was established successfully by the method of overfatigue and excessive sexual life. The scatter plot of gene expression profiles of comparing control group with model group was drawn. Differentially expressed genes were screened, including 2425 up-regulated genes and 3080 down-regulated genes. Among the first one hundred up-regulated genes, 41 genes were known and among the first one hundred down-regulated genes, 62 genes were known. These genes were mainly related to the cellular structure/function, material/energy metabolism, signal transduction/transmission, inflammation/immunization, cell apoptosis, transcription/translation,proliferation/differentiation and cell cycle. Conclusion: The testis gene of kidney-yang deficiency mouse had a wide change. The essence of kidney-yang deficiency syndrome and the theory of the kidney originating and controlling life reproduction were explained on the gene level.

AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis.
●METHODS:Retrospective study. A total of 57 cases (57 eyes ) with complicated cataract with uveitis were involved in the study from Jan. 2015 to Dec. 2015. All cases underwent phacoemulsification and intraocular lens implantation surgery successfully. The postoperative reaction, effect, complications and so on were retrospectively analyzed after phacoemulsification and intraocular lens implantation surgery. The date of visual outcome was analyzed using Non - parametric Wilcoxon test.
●RESULTS: lris were bleed in 21 eyes ( 37%) , 4 eyes ( 7%) with posterior capsule rapture and posterior chamber intraocular lens was not implanted in 4 eyes ( 7%) . The uncorrected visual acuity ( UCVA ) was significantly increased after surgery. The UCVA of 8 eyes (14%) were 0. 1 or better before surgery, and the UCVA of 42 eyes (74%) were 0. 1 or better 3mo after surgery, the difference was statistically significant ( Z=23. 42, P<0. 001). The corneal edema (17 eyes, 30%), uveitis (2 eyes, 4%) and intraocular hypertension ( 1 eyes, 2%) were appeared in postoperative 1d. The corneal edema (3 eyes, 5%) was appeared in postoperative 1wk. The uveitis ( 1 eyes, 2%) was appeared in postoperative 1mo. The corneal edema (1 eyes, 2%), uveitis (2 eyes, 4%) , intraocular hypertension ( 1 eyes, 2%) and after-cataract ( 3 eyes, 5%) were appeared in postoperative 3mo.
● CONCLUSION: The phacoemulsification combined intraocular lens implantation surgical intervention of complicated cataract in patients with uveitis has good effect and fewer complications.

Objective To observe the effects of the Ossatron high-energy shock waves on bone nonunion and delayed union.Methods Between October 2004 and October 2005,18 patients with nonunion and four patients with delayed union were treated with high-energy extracorporeal shock wave therapy(Ossatron,HMT Co., Swiss).Facture lines were located with C-arm X-ray before treatment.Parameters of shock waves were decided according to fracture sites.Patients with unstable fixation received plaster or bracing for 6 to 8 weeks after treatment. After therapy,follow-up radiography was performed at 6 and 12 weeks and monthly afterwards until the fracture united. Results The mean follow-up was 6.7 months(range,3 to 12 months).There were no complications except local petechial hemorrhage and local swelling in 10 patients.Thirteen patients(59.1%)got bony union,including 12 patients(66.7% )with stable internal fixation,and the average healing time was 4.3 months(range,6 weeks to 6 months).Nine fractures(40.9%)still suffered nonunion.Conclusion High-energy shock waves are a good alternative therapy for nonunion and delayed union,with obvious advantages of being non-invasive and safe.

Objective To investigate the histological and biochemical responses associated with periprosthetic osteolysis,including the changes of tumor necrosis factor-?(TNF-?),osteoprotegerin(OPG) and os- teoprotegeria ligand (OPEL) in the interface membrane in rat models so as to understand the mechanisms of these interactions.Methods Twenty-four male SD rats were used in this study.A titanium alloy plug was inserted into each distal femur through the knee joint.Polyethylene particles were injected into the left knee at 2,4,6,8 and 10 weeks after implantation of the plugs.Saline solution was injected into the right knee as the control.The animals were killed 12 weeks after implantation.The distal femur was taken from each knee to make histological sections. The samples were made decalcified and stained with hematoxylin and eosin.The histopathological changes were observed under a light microscope.The concentrations of TNF-?in the membrane were assayed by a ELISA kit and the mRNA expressions of OPG and OPEL extracted from the tissue around the plug were detected by RT-PCR. Results The interface membrane taken from the experimental side was found to contain extensive fibrous tissues which extended deeply into the surrounding hone.TNF-?concentrations in the membrane of the experimental side were higher than in the control membrane.There was a significant decrease of OPG mRNA and a significant increase of OPGL mRNA in the membrane around the plug at the experimental side compared with the control side.Con- clusions Polyethylene particles can induce inflammatory responses around the titanium alloy plug.The increase of OPGL expression and reduction of OPG expression in membrane at the experimental side may be induced by TNF-?. Such changes might contribute to the differentiation of osteoclasts and result in the periprosthetic osteolysis.

Objective To investigate the relationship between CIDE-B change and apoptosis by detecting expression of CIDE-B gene and protein under various injuring conditions(firearm injury and in- cision injury)and comparing neuronal apoptosis.Methods A total of 108 New Zealand rabbits were randomized into firearm injury group,incision injury group and control group.Samples were harvested at different time points after injury for measuring CIDE-B mRNA expression level by RT-PCR,demonstrating morphological distribution of CIDE-B mRNA by in situ hybridization and determining CIDE-B protein level by Western blot.Results Following nerve injury,CIDE-B mRNA expression in spinal cord was en- hanced markedly in the firearm injury group,increased from at day 1,reached peak at day 7,lasted for two weeks and declined after four weeks.CIDE-B mRNA expression was increased late,with small range in the incision injury group.The changes in CIDE-B protein level accorded with those in CIDE-B mRNA level.There was slight CIDE-B mRNA expression,distributing in spinal cord neuronal cytoplasma,in spinal cord tissues in the control group.Conclusions Following peripheral nerve injury,expressions of CIDE-B mRNA and protein are enhanced in spinal cord neurons and distributed in the grey matter of spi- nal cord.Such enhancement is more marked after firearm injury than incision injury.

Objective To explore the feasibility and efficacy of posterior minimally invasive scoliosis surgery in Lenke 5C adolescent idiopathic scoliosis (AIS).Methods From November 2012 to March 2014,a total of 16 patients underwent posterior minimally invasive scoliosis surgery assisted by O-arm three-dimensional CT navigation were included.There were 14 female and 2 male,with an average age of (16.7± 1.6) years (ranged from 14 to 18 years).The mean Cobb angles of lumbar and thoracic curve were 48.7°±5.6°and 24.1°±5.4°,respectively.Results 16 patients were successfully completed the operation,the average operation time was (246±89) min,the average intraoperative blood loss was (192± 105) ml,and the fusion level was 4.9±0.5 on average.A total of 155 screws were inserted in the 16 patients,with a mean implant density of 98.9％±4.9％.All the patients were followed up for (26.4±3.9) months on average.The following radiographic parameters were evaluated before surgery,immediately after surgery and at the last follow-up:curve magnitude,apical vertebral translation (AVT),apical vertebral rotation (AVR),trunk shift,thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL) and sagittal vertical axis (SVA).The accuracy of pedicle screw placement was assessed according to postoperative CT scans.SRS-22 scores and complications were also recorded during the follow-up.Immediately after surgery,the correction rate of main lumbar curve was 80.1％±8.3％,and thoracic curve was 59.3％±8.7％,and a obvious improvement was noted in terms of AVT,AVR,trunk shift and TLK.At the last follow-up,except the increase of SVA from (-27.6± 19.5) mm to (-12.3±6.6) mm,no obvious changes of AVT,AVR,trunk shift,TK,TLK and LL were observed during the follow-up.According to CT evaluation,the satisfactory rate of pedicle screw placement was 94.2％,while the perforation rate was 5.8％ (9/155).Fusion across the facet joint were satisfactory.In SRS-22 assessment,the mean scores of functional,pain,self-image,mental state and satisfaction were (4.3 ± 0.5) points,(4.7 ± 0.6) points,(4.2 ± 0.7) points,(4.2 ± 0.5)points and (4.4 ± 0.6) points.No wound infection,implant failure and neurologic complications were found after surgery.Conclusion Wiltse approach assisted by O-arm three-dimensional CT navigation has the characteristics of small injury,less bleeding,high accuracy placement of pedicle screws and high self-satisfaction of patients.It is a feasible,safe and effective way to treat Lenke 5C AIS.

Objective In the previous study completed in Korea, early three-dimensional conformal radiotherapy concurrent with chemotherapy in rectal cancer after radical surgery demonstrated a better prognosis compared with late radiotherapy. However, with the report of MOSAIC trial, the adjuvant chemotherapy regimen had transferred from 5-Fu alone to combined 5-Fu and Oxaliplatin. We need more evidence to clarify the best radiotherapy timing during the whole period of adjuvant therapy . Methods Patients who met the following criteria were accrued in this study: 18-70 years old, lower anterior resection,pathologically proven rectal adenocarcinoma, stage T3-4 and/or N+, no evidence of distant metastases and KPS≥70. Three dimensional conformal Radiotherapy was started at the fourth week after surgery, which included 45 Gy whole pelvic radiation following by 6-10 Gy tumor bed boost. Oxaliplatin of 50 mg/m2 weekly and Xeloda 625 mg/m2 twice a day, every week from d1-5 were used concurrent with radiotherapy.Toxicity was evaluated and graded by common toxicity critera version 3. 0. The study was designed as Simon two-phase design, in the first phase, a total of 15 patients were accrued, and if more than or equal to 9 patients had grade 3 toxicity, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Otherwise, another 15 patients of the second phase were accrued, we would have 85% power to confirm the high toxicity of more than 50% if 18 out of 30 patients had grade 3 toxicity. Results From July 2008 to December 2008, 15 patients were treated with early radiotherapy concurrent with combined chemotherapy, Grade 3 gastrointestinal toxicity occurred in 12 patients and Grade 3 hematologic toxicity occurred in 2 patients. According to Simon design, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Conclusions For locally advanced rectal cancer patients, whole pelvic radiotherapy concurrent with oxaliplatin and xeloda had severe toxicities. Further studies are needed to decrease toxieities.