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Objective@#To discuss the misdiagnosis of pyriform sinus fistula and to better understand this kind of illness.@*Methods@#The analysis was based on twenty-eight patients with congenital pyriform sinus fistula aged from 11 months to 14 years, with the median age of 5 years, and who were surgically treated from January 2013 to January 2017 in Kunming Children′s Hospital.Twenty patients were misdiagnosed in other hospital.After the routine examination of neck ultrasound and enhanced CT, internal fistula was found by self-retaining laryngoscope, traced by methylene blue, and excised by high ligation.@*Results@#Twenty patients were misdiagnosed.The misdiagnosis time ranged from 6 months to 3 years.Under self-retaining laryngoscope, piriform fossa fistula were found in all patients.Nineteen fistula were found in the left and 1 in the right.The fistula in patients was unilateral.Seven cases were misdiagnosed as suppurative lymphadensitis, undergone abscess incisional drainage many times.Three cases were misdiagnosed as thyroglossal duct cyst and performed excision of thyroglossal duct cyst.One case was treated by extended Sistruck operation again because the doctor considered that excision of middle segment of hyoid bone was not enough and the fistula was not ligated completely.One case was misdiagnosed as second branchial cleft fistula on the right side of the neck.Nine cases were misdiagnosed as hyroid-associated diseases including 2 cases suppurative thyroiditis, 2 cases subacute thyroiditis and 5 cases thyroid neoplasms.Among them, 2 cases underwent partial thyroidectomy.All the patients were treated with high ligation of fistula under general anesthesia.The operation was smooth, and no hoarseness, bucking and pharyngeal fistula occurred after the operation.Postoperative follow-up time ranged from 12 months to 4 years and the median follow-up was 18 months without recurrence.The diagnosis was confirmed pathologically.@*Conclusions@#Pyriform sinus fistula in children was uncommon and easily misdiagnosed in clinic.The majority of physician including some otolaryngologists were lack of understanding of the disease.It should be regarded as one of the important differential diagnosis of neck mass in children.Children with recurrent left neck infection and/or abscess should be highly suspected.Self-retaining laryngoscopic examination can make a definite diagnosis and high ligation of the fistula through the external neck approach can achieve good therapeutic effect.
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Objective To explore the expression level of Ki67 and its correlation with clinicopathological types and prognosis of patients with breast cancer.Methods Clinical data of 93 patients with breast cancer and 20 patients with benign breast diseases were collected from Jan.2013 to Dec.2015,and the correlation between Ki67 and pathological parameters and laboratory parameters were analyzed.Results Among the 93 patients with breast cancer,the Ki67 index was 1% to 90%,with median of 21.65%.Ki67 index was correlated with tumor grade,tumor size and human epidermalgrowth factor receptor-2(HER2,P0.05).Ki67 index of patients with triple negative breast cancer,patients with non-triple negative breast cancer and patients with benign breast diseases were 30.15%,20.26% and 4.67%,which were with significant difference(P<0.04).Ki67 index was also related to the breast cancer subtypes(P<0.05),and serum potassium and hematocrit levels of patients with breast cancer(P<0.05).Conclusion Ki67 index could be used for the diagnosis,treatment and prognosis of patients with breast cancer.
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<p><b>OBJECTIVE</b>To compare the effects of flipping moxibustion ofmedicine combined with western medication and simple western medication for rheumatoid arthritis with cold dampnesssyndrome.</p><p><b>METHODS</b>Eighty patients were randomly assigned into an observation group and a control group, 40 cases in each group. Oral methotrexate (1 time a week) and sulfasalazine (twice a day except the day for methotrexate) were used in the two groups. Patients in the observation group were treated with flipping moxibustion ofmedicine, twice a week. The main acupoints were Shenshu (BL 23), Guanyuan (CV 4), Zusanli (ST 36), Yinlingquan (SP 9), and the matching acupoints were in the meridians related to the disease location. All the treatment was given for continuous 4 weeks. The TCM symptom score, visual analogue scale (VAS) score, blood sedimentation (ESR), rheumatoid factor (RF) and C-reactive protein (CRP) were observed before and after treatment. The effect was evaluated.</p><p><b>RESULTS</b>The total effect rate in the observation group was 95.0% (38/40), which was better than 77.5% (31/40) in the control group (<0.05). After treatment, the VAS score, TCM symptom score, RF, ESR, CRP levels decreased in the two groups (all<0.05), with better effects in the observation group (all<0.05). The adverse reactions in the observation group were lower than those in the control group.</p><p><b>CONCLUSION</b>Flipping moxibustion ofmedicine combined with western medication for rheumatoid arthritis with cold dampnesssyndrome are better than simple western medication, which are safer and more effective.</p>
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[ ABSTRACT] AIM: To observe the effect of microRNA-19a ( miR-19a) on the lipid catabolism of hepatocyte LO2, and to explore the potential mechanism.METHODS: miR-19a was over-expressed or silenced by transfection of miR-19a mimics or miR-19a inhibitor into LO2 cells, then the mRNA level of miR-19a was detected by real-time PCR.The potential target of miR-19a was found by the method of bioinformatics through internet website.The effect of miR-19a on the 3’ UTR of peroxisome proliferator-activated receptorα(PPARα) was measured by dual luciferase reporter assay, and the protein level of PPARαand its 2 major downstream rate-limiting enzymes involved in lipid catabolism, acyl-coenzyme a dehydrogenase (ACADM) and carnitine palmitoyltransferase 1A ( CPT1A), were detected by Western blotting.Mean-while, the effect of miR-19a on the generation of ketone body was measured by beta-hydroxybutyric acid (β-OHB) detec-tion assay.RESULTS:The mRNA level of miR-19a was dramatically elevated by the transfection of miR-19a mimics, and sharply decreased by the transfection of miR-19a inhibitor (P<0.05).PPARαwas found as a potential target of miR-19a, and dual luciferase reporter assay and Western blotting confirmed the regulatory effect of miR-19a on the expression of PPARα, with the protein level changes of ACADM and CPT1A.miR-19a mimics down-regulated, while miR-19a inhibitor up-regulated the concentration ofβ-OHB in LO2 cells (P<0.05).CONCLUSION:miR-19a regulates the lipid catabo-lism of hepatocytes by targeting the PPARαand its 2 downstream rate-limiting enzymes.
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Objective: To explore the relationship between parental rearing behavior and personality disorder. Method: Descriptive study was carried out in one key-university in Beijing. Two thousand two hundred and five freshmen were investigated with Personality Diagnostic Questionnaire-Revised (PDQ-R) and EMBU scale. Fifty-five personality disorder cases were diagnosed by International Personality Disorder Examination (IPDE). Results: The scores of emotional warmth, over-protection, and favoring subject of the maternal were higher than those of the paternal. Parental scores of EMBU factors were highly correlative. The scores of rejection, overprotection, favoring subject in personality disorder cases were significantly higher than those in control group, while the score of emotional warmth was significantly lower. Conclusion: Inappropriate parental rearing behavior is a risk factor of personality disorder.
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Based on the function of nourishing blood and activating blood circulation,Naornaishu(NMS)composed of Rhizome Chuanxiong,Radix Salvice Miltiorrhizae,etc.has been used to treat cerebral arteriosclerosis and infarction.65 Patients with cerebral arteriosclerosis were treated with NMS for about two months and got a total effective rate of 98.5%.50 cases with eerebral infarction were also observed.It was shown that its effect on impro- ving myodynamies,alleviating aphasia,relieving dizziness and turning patholo- gic reflex negative was 86.4%,76.9%,100% and 38.0% respectively.No side effects were obser(?)ed during the period of more than two years of clinical applications.Therefore,NMS is regarded as an ideal medicine for preventing and treating cerebrovascular diseases.
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Results showed that its action was satisfactory.Theclinical effects of all three kinds of disease were betterthan that of the control group,especially on the im-provement of deficiency of blood and Qi(P