Objective To investigate the clinical efficacy of repairment using ear endoscope for small perfo-ration of the tympanic membrane after traditional tympanoplasty.Methods A retrospective analysis of 42 cases of repairment using ear endoscope for small perforation of the tympanic membrane after traditional tympanoplasty was investigated.Adipose tablet of earlobe to repair small perforation or perichondrium of hircus for medium perforation was used.Results The success rate after one repairment of small perforation was 82.76%(24 /29).The success rate for medium perforation was 61.54%(8 /13).9 cases received the repairment for 2 times or even more to heal the tym-panic membrane.The mean improvement of air conduct at language frequency was 20.03dB by 6 months after the successful operations (t =1.98,P <0.05)and air bone guide.The mean difference between the air conduct and bone conduct decreased as much as 19.82dB (t =1.86,P <0.05)with statistical significance.Conclusion The success rate was high to repair the perforation using ear endoscope after traditional tympanoplasty.The hearing was improved obviously and the patients were very compliant.

Objective: To study the expression and clinical value of glycogen synthase kinase-3β(GSK-3β), Dickkopf-1(DKK-1) and β-catenin in patients with proximal gastric cancer. Methods: From April 2016 to April 2017, 47 patients with proximal gastric cancer in Chengfeng Hospital of Daqing Oilfield Group were enrolled in this study.Immunohistological tests were performed in all patients' lesions, adjacent tissues and healthy tissues.The effects of different factors on the expression of GSK-3β and DKK-1 were compared. Results: The positive expression rate of GSK-3β in the normal tissues of patients with proximal gastric cancer was 70.21% (33/47), which was higher than those in the lesions and adjacent tissues[21.28% (10/47), 21.28%(10/47)](χ²=31.985, P<0.01). The positive expression rates of DKK-1 and β-catenin in the gastric cancer tissues were 38.30% (18/47), 82.98% (39/47), respectively, which were higher than those in the adjacent tissues and normal tissues[8.51% (4/47), 8.51% (4/47), and 6.38% (3/47), 2.13% (1/47)](χ²=20.517, 88.471, all P<0.01). The GSK-3β positive expression rate was higher in patients with tumor node metastasis (TNM) stage I-II, moderately well differentiated, infiltrated more than 50%, non-metastatic lymph nodes (P<0.05). The DKK-1 positive expression rate was higher in patients with TNM stage III-IV, moderately well differentiated and less than 50% infiltrated lymph nodes (P<0.05). Conclusion GSK-3β, DKK-1 and β-catenin are important indicators in the development and metastasis of gastric cancer.The above indicators have clinical value in the diagnosis and evaluation of curative effect.

Objective To summarize the clinical treatment experience of blood culture-negative infective endocarditis,and to explore the surgery chance and therapeutic strategy of blood culture-negative endocarditis. Methods One hundred and sixty-six patients who were diagnosed blood culture-negative endocarditis in the Aisa Heart Hospital of Wuhan from Jul. 2008 to Dec. 2012 were recruited in the study. Broad-spectrum antibiotics including cefuroxime axetil and levofloxacin were used before the result of blood culture,and sensitive antibiotics were selected to control patient's condition when getting the result of blood culture. But broad-spectrum antibiotics were continuously used to the blood culture-negative endocarditis until stable condition. When the conditions were stable,active preparation before surgery should be carried out. Thoroughly clear the vegetation and protect the cardiorespiratory function during operating. Kata-step antibiotics were used to control patient's condition until normal temperature,as well as the number of leukocytes decreased,blood sedimentation normalized and C-reaction protein decreased. Then,the narrow-spectrum antibiotics were selected including cephalosporin until discharged from hospital,and continued treatment of antibiotics for 4 - 6 weeks. Results Five patients died after the operation,including 1 case died of low cardiac output syndrome,2 cases died of multiple organ failure,1 case died of septicemia and the 1 case died of cerebral embolism. All the other patients discharged from hospital successfully. Conclusion The patients with blood culture-negative IE should be controlled rapidly. The duration and dose of antibiotics should be enough. Active operative preparation should be taken and then surgery timely. Thus,the hospital mortality could decrease and prompt the long-term outcome.

Coronary Disease ; Exercise Test ; Exercise Therapy ; Heart Rate ; Humans ; Myocardial Ischemia

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.
Acetylation ; Animals ; Cold-Shock Response ; Epigenesis, Genetic ; Macrophages/metabolism* ; Mice ; Mitochondria/metabolism*

Objective To investigate the correlation between CYP2C19*2 gene polymorphism and efficacy of anastrozole in postmenopausal women with breast cancer. Methods The polymorphisms of CYP2C19*2 gene in postmenopausal women with postmenopausal breast cancer were detected by PCR. Results The A allele frequency of the CYP2C19*2 gene(OR=3.146,95% CI:1.244~7.275,P<0.05)was a risk factor for the efficacy of post-menopausal breast cancer patients.The survival rate was lower than that of GG(χ2=6.26,P<0.05).After treat-ment,the FSH and LH of GG patients were significantly lower than those of AA and GA(t=5.29,6.47,P<0.05). Multivariate logistic regression analysis showed that anastrozoleand CYP2C19*2 gene polymorphism were indepen-dently associated with serum FSH and LH levels in postmenopausal women with breast. Conclusion CYP2C19*2 gene polymorphism is associated with anastrozole in the treatment of postmenopausal breast cancer.

Objective:To evaluate the clinical efficacy and safety of Longmu Zhuanggu granule for the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency. Method:This multicenter stratified， block-randomized， double-blind， double-dummy， positive drug （pidotimod granule） parallel controlled， and non-inferiority trail intended to included 240 children patients and divided them into the experimental group （n=120） and the control group （n=120） at the ratio of 1∶1. Patients in both groups were treated for eight successive weeks and followed up for 12 months. The cure rates， numbers of respiratory infections， average courses of disease， curative effects of traditional Chinese medicine （TCM） syndrome， curative effects of individual symptoms， curative effects of immune indexes， and safety indexes between the two groups were observed and compared. Result:A total of 237 subjects were collected from 10 research centers， including 119 cases in the control group and 118 in the experimental group. There were 236 cases enrolled into the full analysis set （FAS）， 210 into the per-protocol set （PPS）， and 236 into the safety set （SS）. The baseline data of the two groups were not significantly different from each other， indicating that they were comparable. The cure rates of the experimental group and control group were 75.21% （88/117） and 73.95%（88/119）， respectively， with the 95% confidence interval （CI） of difference between the two groups being 1.26% （-9.85%，12.37%） for FAS and 3.81% （-6.28%，13.90%） for PPS. The 95% CI fell within the 10% non-inferiority margin， implying that non-infertility test of the cure rate in the treatment of endpoint disease was valid， and the conclusions of FAS and PPS analysis were consistent. There was no significant difference in the number or course of upper respiratory infection， bronchitis， and pneumonia. The difference in curative effects of TCM syndrome between the two groups after four weeks of treatment was not remarkable. After eight weeks of treatment， the total effective rate of the experimental group was 84.62%（99/117）， statistically higher than 78.15%（93/119） of the control group（χ²=-3.26，P<0.05）. There were no significant differences in the disappearance rates of individual symptoms between the two groups after four weeks of treatment. After eight weeks of treatment， the experimental group and control group exhibited the disappearance rates of 67.50%（54/80） and 47.37%（36/76） for shortness of breath and laziness to speak， 75.00%（54/72） and 53.33%（40/75） for poor appetite， 54.55%（60/110） and 37.84%（42/111） for hyperhidrosis， respectively， with obviously better outcomes observed in the experimental group （P<0.05，P<0.01）. The inter-group comparison revealed significant differences in immune indexes after eight weeks of treatment. As demonstrated by comparison with the situations before treatment， IgA， IgG， IgM， and CD4 did not change significantly after treatment. Except for CD8 in the experimental group (P<0.05), there was no significant difference in other immune indexes before and after treatment There was no significant difference in the incidence of adverse reactions. Conclusion:Longmu Zhuanggu granule is not inferior to pidomod granule in the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency， and it exhibits good safety， implying its promising clinical application value.

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy

Adult ; Aged ; Aged, 80 and over ; Biological Assay ; Cerebrospinal Fluid/chemistry* ; China ; Female ; Humans ; Male ; Middle Aged ; Prion Diseases/cerebrospinal fluid* ; Young Adult

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.