Adult ; Cholesteatoma, Middle Ear ; Humans ; Male

Objective To evaluate the diagnostic value of CT in epileptic pathogeny. Methods Clinical data and CT findings of 1542 patients with epilepsy were studied retrospectively. Result The positive CT finding was 42.35％ . The epileptogenic focus which were found by CT, included in turn: brain atrophy, and excephaloma and cerebral congenital or development disorder, and cerebrovascular disease, and encephalomalacia, and unidentified hypodense or hyperdense lesions, calcification, and infection, and postoperative changes, and trauma and the sequelaes of hypoxic－ ischemic encephalopathy .Conclusion CT is helpful to determine the diagnosis， types and therapy of epilepsy.

Objective To observe the operation of Nav1.6 voltage-gated sodium channels in rats with acute cerebral injury after electroacupuncture therapy and investigate the mechanism.Methods Male Sprague-Dawley rats were randomly divided into an ischemia control group (IC,n =48),an electroacupuncture group (ET,n =48),a nimodipine therapy group (NT,n =48) and a sham operation group (SO,n =24),and were treated accordingly.A model of acute cerebral ischemia was induced by occlusion of the right middle cerebral artery using the suture method.The expression of Nav1.6,the concentration of Ca2+ and infarct volume were observed at 6 h,1 d,2 d and 3 d after ischemia with the real-time quantitative fluorescence PCR,immunofluorescence and 2,3,5-triphenyl tetrazolium chloride methods,respectively.Results The Joshua score for neural function was zero in the sham operation group,and increased gradually in the three other groups 6 h and1 and 2 d after ischemia.The average Joshua score 3 d after ischemia was significantly lower than 1 d earlier in each group.In the ET group the expression of Nav1.6 was significantly upregulated at first,followed by a significant decrease.The concentration of Ca2+ behaved similarly.However,no significant changes were observed in the infarction volume percentage.At 3 d after ischemia the expression of Nav 1.6,the Joshua grades,the Ca2+ concentrations and the infarction volume percentage were all significantly lower in the ET group compared with the IC,NT and SO groups.Conclusion Electroacupuncture therapy after acute cerebral ischemia can inhibit the expression of Navl.6,reduced Na + inflow and calcium overload,and mitigate acute cerebral ischemic injury,at least in rats.The protective effect may be attributed to inhibiting the expression of Nav 1.6.

Objective To evaluate the ability to show anatomical structures of the normal middle ears with helical CT virtual endoscopy(CTVE).Methods CTVE were performed to observe anatomical structures of bilateral middle ears in 100 healthy volunteers.Results Anatomical structures of middle ears were displayed stereoscopically by CTVE from multiple views.But superficial and ting structures were showed pooly.Conclusion CTVE is a new noninvasive imaging tool for observe stereoscopically auditory ossicudar chains.

Inquisition language,as the information carrier on observing and describing disease status,makes it possible for patients to communicate well with doctors to acknowledge disease information.In order to make inquisition language possess specific properties of medical conversation,doctors need to master language skills in procedural inquisition,proper listening and responding to inquisition,distinguishing inquisition,transitional inquisition and secret-involved inquisition.Upholding inquisition language with courtesy,comfort,being explanatory,encouraging,and protecting is the basic requirement of clinical ethics.

BACKGROUND:Changes of both stem cell markers and endothelial cell phenotype help understand characteristics of endothelial progenitor cells during adherent differentiation.However,there is still no specific cell marker to distinguish from mature endothelial cells.OBJECTIVE:To study the changes of stem cell markers and endothelial cell phenotype during the differentiation of rat peripheral blood rnononuclear cells into endothelial cells.DESIGN.TIME AND SETTING:Cell observation study was performed in the Laboratory of Cardiac Surgery,Qingdao Municipal Hospital between June 2004 and December 2008. MATERIALS:Peripheral blood was drawn from male SD rats to obtain mononuclear cells by Ficell density gradient centrifugation. METHODS:Mononuclear cells were in vitro cultured in fibronectin culture medium and induced by vascular endothelial growth factors(VEGF)and basic fibroblast growth factors(bFGF)in order to stimulate a differentiation into endothelial cells. MAIN OUTCOME MEASURES:Adherent cells in the culture system were identified for CD31,CD34,Rk-1 and vWF with immunochemistry within 1-7 days.RESULTS:The expressions of CD31.CD34,FIk-1.vWF on adherent cells were different in different time durations.The expressions of CD31 and CD34 started on the 2nd day of culture.reached the peak on the 4th day,gradually decreased and even disappeared on the 6thday.While.FIk-1 expressed on the 3rd day of culture,gradually increased,and reached at the peak on the 7th day.vWF expressed gradually until 100%on the 7th day. CONCLUSION:The differentiation of peripheral blood stern cells into endothelial progenitor cells is characterized by the appearance of endothelial cell phenotypes and the disappearance of stern cell markers.both in the manner of gradual progression.

Objective To explore the clinical application and safety of treatment of percutaneous radioactive 125I seed implantation treatment in lung metastases under CT guidance.Methods Twenty-seven lung metastatic malignancy cases (67 nodules) were studied.Eighteen cases (46 nodules) were hepatic cancer,4 cases (9 nodules) were prostate cancer,and 5 cases (12 nodules) were breast carcinoma.Diameters of lung nodules ranged from 0.5 cm to 4.0 cm with an average diameter of 2.1 cm.125I seeds were embedded under CT guidance,using 2 to 33 particles/nodule with an activity of 18.5 to 29.6 MBq/grain for each particle.Tumor matched peripheral dose was 90-120 Gy.Postoperative validation and quality evaluation followed.Results Four months later,24 nodules showed CR,30 showed PR,5 showed NC and 8 showed PD.The total effective rate was 80.6％ (54/67).In the course of treatment,11 patients had pneumothorax,3 had heavy lung compression and 4 had hemoptysis.All conditions were improved by pleural puncture or under close follow-up observation.Conclusion 125I seed implantation is an effective and safe technique in treatment of metastatic lung tumors under CT guidance.

Objective To investigate the clinical results of minimal invasion spinal surgery (MISS) in treating tibial plateau fractures to provide best procedure for such treatment.Methods The study involved 36 cases with tibial plateau fractures resulted from traffic injury,fall-from-height injury and strain injury including 24 males and 12 females at age of 19-65 years (average 42.6 years).According to Schatzker classification,there were seven cases of typeⅠ,five typeⅡ,five typeⅢ,five type IV,sev- en typeⅤand seven typeⅥ.All cases were treated by different methods of MISS.Results Follow up for 8-24 months in 35 cases showed fracture healing within 3-4 months,without severe complications such as poor wound healing,infection or osteofascial compartment syndrome.Meanwhile,no traumatic knee osteoarthritis,inversion or eversion of the knee were found.The mean range of knee motion was 94?,with fine knee function in 32 cases (91.4%) according to Merchant score.Conclusions Treatment of tibi- al plateau fractures should adopt limit incision,indirect reduction and biofixation to take place widespread exposure and rigid plate fixation.MISS is safe and effective for tibial plateau fractures.

Objective To observe the changes of calcitonin gene-related peptide(CGRP) -immunoreactive positive nerve fibers innervation in bone tissue of femoral heads during the pathological process of early steroid-induced avascular necrosis of the femoral head (SANFH), and explore its significance.Methpathological group of SANFH was induced.Immunohistochemical technique was used and the changes of CGRP-immunoreactive positive nerve fibers innervation in weight bearing area of the femoral heads during the pathological process of early SANFH were observed.Result The number of CGRP-immunoreactive nerves increased first and then decreased ( Peaked at 6 weeks, 10.28 ± 0.66 ), but it was more than that ofnormal control group.There was significant difference between two groups ( P ＜ 0.01 ).Conclusion There were changes in the distribution of CGRP-immunoreactive positive nerves fiber during the process of bone repair after SANFH.CGRP-immunoreactive positive nerves fiber might take part in the process of bone repair in SANFH.

Objective To investigate the synthesis of heat shock protein 70 (HSP70) induced by norepinephrine preconditioning on donor heart and its effects on myocardial cell apoptosis and apoptosis related proteins. Methods 18 Wistar rats were random divided into 2 groups, with 9 in each group. The rats in the control group were intraperitoneally injected with 0.5 ml saline. After 24 hours, hearts were isolated and stored with histidine-tryptophan-ketoglutarate (HTK) solution at 4 ℃ for 3 hours to establish Langendorff isolated heart models, and then isolated hearts were perfused by Langendorff model with Krebs-Hense leit (K-H) solution for 2 hours. The rats in the experimental group received intraperitoneally 3. 1 μmol/kg (0. 53 mg/kg) noradrenaline bitartrate that was dissolved in saline and hearts were isolated and stored after 24 hours. Followed process was the same as that in the control group. Myocardial HSP70, Bcl-2, Bax content, apoptosis index were measured, cell structures were observed under light and electron microscope.Results HSP70 in the experimental group were higher [(17.78 ± 1.82)%] than those in control group [(5.22 ± 1.05)%], and biochemical indicators in texperimental group[(41.88 ± 5.09)%, (22.61 ±3. 49 ) %] were better than those in control group [(31.36 ± 3. 27 ) %, ( 40. 52 ± 4. 1 7) %]. There were alleviated ultrastructure injures in experimental group compared with those in control group. Conclusions This study demonstrated that norepinephrine preconditioning could induce high expression of HSP70 and it could play a very important role during ischemia-reperfusion. It could protect the structure and function of myocytes in isolated rat hearts and inhibited myocardial apoptosis.