OBJECTIVE In order to explore the site of the nasal valve.METHODS The distribution of nasal airway resistance were studied in normal adults, and patients with chronic rhinitis,patients underwent partial inferior turbinectomy,patients with the deviation of nasal septum and the patients underwent correction of the nasal septum.RESULTS Before the nasal mucosa decongested,the site of the most effect on the NAR was located in pyriform fossa in normal adults. After the nasal mucosa decongested,the site of the most effect on the NAR was located in the ostium internum.The most significantly site which effect on the NAR were pyriform fossa and the ostium internum before and after operation in the patients who suffer from chronic rhinitis.The site of the most effect on the NAR was in the place of deviation of the nasal septum before operation and in the pyriform fossa after operation.CONCLUTION The result suggested that the site of the nasal valve is changeable and related to the condition of contraction and relaxation of the nasal mucosa and the extent of nasal patency.

Objective:To investigate the influencing factors for orthostatic hypotension(OH)in elderly patients with hypertension.Methods:This was a case-control study.A total of 224 patients with hypertension aged over 65 years were included.After resting for more than 5 minutes, subjects had their blood pressures measured in the supine and standing position at 0 min, 1 min, 2 min and 3 min.OH was defined as a fall in systolic BP of more 20 mmHg(1 mmHg=0.133 kPa)and/or diastolic BP below 10 mmHg of baseline within 3 min in the upright position.Subjects were divided into the OH group( n=34)and the non-OH group( n=190). Baseline data, comorbidities and differences in medications were compare between the OH group and the non-OH group, and the influencing factors for OH were analyzed. Results:The proportion of drinkers was higher in the OH group than in the non-OH group(29.4% or 10/34 vs.7.4% or 14/190, χ2=14.649, P<0.01). Both systolic pressure(139.0±22.1 mmHg vs.124.5±16.3 mmHg, t=-3.661, P<0.01)and diastolic pressure(77.6±6.3 mmHg vs.69.2±9.0 mmHg, t=-6.696, P<0.01)in the supine position were higher in the OH group than in the non-OH group.The proportions of patients with diabetes(47.1% or 16/34 vs.25.3% or 48/190, χ2=6.731, P<0.05)and stroke(41.2% or 14/34 vs.24.2% or 46/190, χ2=4.233, P<0.05)were higher in the OH group than in the non-OH group.The proportion of patients receiving α receptor blockers was higher in the OH group than in the non-OH group(23.5% or 8/34 vs.4.2% or 8/190, χ2=16.228, P<0.01). After adjusting for factors such as alcohol consumption, diabetes, stroke and other differences between the OH and non-OH group, logistic regression found patients with alcohol intake( OR=5.274, 95% CI: 1.990~13.982, P<0.01), diabetes( OR=2.744, 95% CI: 1.213~6.208, P<0.05)and using α receptor blockers( OR=8.812, 95% CI: 2.835~27.383, P<0.01)had a higher risk of OH. Conclusions:OH is very common in elderly patients with hypertension.Alcohol consumption, diabetes mellitus and the application of α receptor blockers can increase the risk of OH.

The Au-PDA-Fe3O4 decorated graphene oxide electrode was modified with Prussion blue-secondary antibodies for determination of cancer biomarker α-fetoprotein (AFP) with great sensitivity.Scanning electron microscopy (SEM), X-ray diffraction (XRD) and ultraviolet-visible absorption spectrometry were used to characterize the structure of the material.Greatly enhanced sensitivity for the cancer biomarker is based on a dual signal amplification strategy.First, Fe3O4-PDA-Au used for the biosensor platform increased the surface area to capture a large amount of primary antibodies (Ab1), which resulted in amplification of the detection response.Second, graphene oxide allowed several binding events of PB-Ab2.Enhanced sensitivity was also achieved by introducing the multibioconjugates of Ab2-PB-GO onto the electrode surface through sandwich immunoreactions.The test result shows that there are linear relationships between current and AFP concentrations ranging from 0.005 ng/mL to 1 ng/mL and 1 ng/mL to 20 ng/mL, with the low detection limit (LOD) of 1.0 pg/mL.This immunosensor is simple, low-cost and sensitive and shows a great potential in biomedicine, clinical diagnosis and health examination.

Objective To discuss and observe the clinical effect of intervertebral pedicle internal fixation and debride?ment combined with bone graft through posterior approach/trans-intervertebral space approach on the treatment of uni/multi-segmental lumbosacral vertebral tuberculosis (TB). Methods A cohort of 37 patients, with single or multiple segmental ver?tebral destruction due to TB, were treated by trans-intervertebral debridement, posterior pedicle screw system internal fixa?tion and intervertebral bone graft. All patients underwent X-ray,CT and MRI examination to observe the combination treat?ment effect. Results Most patients (n=34) enjoyed primary healing, in which include only 4 cases that presented symptom of nerve root stretch injury during operation but all recovered after 3 months. Other 3 patients underwent secondary healing due to sinus but two were rectifying with anti-TB therapy and wound dressing. The other 1 case suffered from sinus tract was healed through second debridement and rectifying therapy. X-ray, CT and MR at 6 months after operation indicated that all patients present great graft osseous fusion, good recovering of height of vertebral body without kyphosis deformity nor internal fixation loosening nor screw breakage. Conclusion Intervertebral pedicle internal fixation and debridement combined with bone graft through posterior approach/trans-intervertebral space approach is with minimum invasion but good graft fusion ef?fects, harder fixation and satisfactory clinical effects in the treatment of uni/multi-segmental lumbosacral vertebral tuberculosis.

Objective To explore the effects of intensity modulated radiation therapy (IMRT) on lung function in patients with non small cell lung cancer (NSCLC) ,analyze relationship between lung function indexes and radiation pneumonitis (RP) incidence rate ,dose volume histogram (DVH) parameters and incidence degree of RP .Methods 52 patients without operation first radiother‐apy patients were included ,all with Karnofsky score (KPS) ≥ 80 points .Detection of IMRT ,before the end of the end ,first months ,third months of forced vital capacity (FVC) ,forced expiratory volume in one second (FEV1 .0) and diffusion capacity of carbon monoxide (DLCO) change were conducted .The incidence and degree of RP were measured ,and got the V20 and V30 value in DVH .By Spearman correlation analysis ,the relationship between pulmonary function index and the incidence of RP ,V20 ,V30 and RP was analyzed .Results Among the 52 patients ,49 patients were followed up ,the follow -up rate was 94 .2% .In the 49 pa‐tients ,two cases were excluded in the lung recurrence or lung metastasis patients ,thus a total of 47 patients were included in the fi‐nal study .There were 18 cases of RP ,the incidence of RP was 38 .30% .In the third month ,FEV1 .0 and DLCO were significantly decreased than that before radiotherapy (P<0 .05) ,FVC had no significant change (P>0 .05) .Correlation analysis showed that FVC ,FEV1 .0 and DLCO and RP were positively correlated (r=0 .451 ,0 .405 ,0 .635 ,P<0 .05);and V20 ,V30 and RP was posi‐tively correlated (r=0 .689 ,0 .725 ,P<0 .05) .Conclusion the larger the NSCLCV20 ,V30 value ,the more serious the RP would be ,thus they could be predictor of RP degree .

Objective To evaluate the safety and feasibility of ketamine-propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization.Methods Eighty-five children with congenital heart disease undergoing cardiac cathete-rization were randomly divided into ketamine group(K group,n=44)and ketamin-propofol group(KP group,n=41).K group:1 mg?kg-1 ketamine was injected intravenously and then infused at 50 ?g?kg-1?min-1 for anesthesia maintenance.KP group:anesthesia was induced with ketamine 1 mg?kg-1 and propofol 1 mg?kg-1 intravenously,and maintained by continuous infusion of ketamine(16.7 ?g?kg-1?min-1)and propofol(33.3 ?g?kg-1?min-1).Electrocardiogram,blood pressure,pluse,respiratory frequency,saturation of blood oxygen were continously monitored.Results Hemodynamic and respiratory function were stable in both 2 groups.Ketamine consumption in K group was significantly more than that in KP group[(52.1?2.8)?g?kg-1?min-1 vs(25.3?7.3)?g?kg-1?min-1],eye opening time and recovery time were also longer in K group than those in KP group [(50.2?16.5)min vs(40.4?18.3)min].Conclusion The ketamine-propofol mixture was a safe,efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.

Objective To evaluate the effectiveness of multiple spiral CT angiography in diagnosis of pulmonary embolism.Methods 16 patients clinically suspected of pulmonary embolism underwent multiple spiral CT angiography.Emboli were found in the 8 patients of all on multiple spiral CT angiography.5 of the patients were reexamined with this method 20 to 30 days after thrombolysis. Results In 8 patients with pulmonary embolism,43 vessels were involved with pulmonary embolism.The presence of pulmonary embolism on CT was seen as a total occlusion,partial filling defect,mural filling defect et al;dilated of pulmonary artery trunk;all signs with deceleration of pulmonary blood or “mosaic sign”. 5 patients were reexamined with this method.The emboli dissoved partly or entirely.Conclusion Multiple spiral CT angiography is a noninvasive and effective method for examining pulmonary embolism.

BACKGROUND: Impaired glucose tolerance(IGT) is mainly related to genetic factors and environmental factors including excessive calorie intake and obesity. Insulin resistance(IR) plays a major role in the onset of IGT.OBJECTIVE: To investigate the relationship between erythrocyte insulinase activity(EIA) and IR in patients with IGT soas to provide theoretic basis for improving IR in patients with IGT by exercise.DESIGN: Observational and comparative study based on IGT patients as the subjects and adults with normal glucose tolerance as controls.SETTING: Department of endocrinology of a hospital affiliated to a military medical university.SUBJECTS: The study was conducted in the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA, from January 2001 to April 2003. A total of 50 inpatients and outpatients with IGT, 26 males and 24 females aged(52 ± 7) years, were randomly selected. Inclusion criteria: those whose diagnosis met the WHO 1999 for criteria oral glucose tolerance test (OGTT) and whose heart, liver and kidney functions and blood test were within the normal range without taking any antidiabetics. Exclusion criteria: those who had liver and kidney diseases, infection, malignant tumor, coronary heart disease, cerebrovascular disorder and connective tissue disease. The patients with IGT were divided into 2 subgroups according to the presence of abnormal fasting plasma glucose (FPG).Subgroup A consisted of 20 patients (9 males and 11 females) with IGT accompanied with impaired FPG. Subgroup B was composed of 30 IGT patients (17 males and 13 females) with normal FPG. Twenty adults with normal glucose tolerance were set as control group(20 females and 10 males) with the age of(48 ± 12)years.METHODS: EIA was measured with the method of radioenzymatic assay in all subjects. Blood sugar, serum insulin and glycosylated hemoglobin were also measured, and homeostasis model analysis-insulin resistance (HOMA-IR) index was calculated for estimation of insulin sensitivity.MAIN OUTCOME MEASURES: The differences and correlation between EIA and HOMA-IR in IGT patients of each group.RESULTS: EIA, serum fasting insulin and HOMA-IR indexes of the patients with IGT were significantly higher than those of the controls ( P < 0.01 or P < 0.05) . EIA and HOMA-IR of the patients in subgroup A was significantly higher than those in subgroup B ( P < 0. 01 ). Linear regression analysis showed that EIA had significant positive correlation with serum fasting insulin, glycosylated hemoglobin and HOMA-IR indexes( r = 0.51, 0.44,0.49, P <0.01).CONCLUSION: The degradation rate of erythrocyte insulinase in patients with IGT tolerance is significantly higher than that of normal persons, and is closely related to the onset and development of insulin resistance.

Objective To observe the effect of Changji'an Prescription(CP) on T lymphocytes count and 5-hydroxytryptamine(5-HT) secretion in rats with diarrhea predominant irritable bowel syndrome(IBS).Methods Forty-six neonatal SD rats were randomized into normal group,model group,low-,middle-and high-dose CP groups(0.94,1.88 and 3.76g?kg-1?d-1 respectively),and Bupi Yifei Pills group(6.76g?kg-1?d-1).Continuous internal rectal stimulation with acetate was used to induce the rat model of intestinal hypersensitive IBS.Flow cytometer was used for the quantitative analysis of peripheral levels of T lymphocytes subsets CD+3,CD+4 and CD+8,and immunohistochemical method was used to observe 5-HT-positive cells number and the immunostaining intensity in the bowels of rats.Results In the model group,the defecation volume and the intestinal sensitivity were increased,CD+4 level and CD+4/CD+8 decreased,CD+8 level increased,5-HT-positive cells number and the immunostaining intensity elevated(P

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