Objective To investigate the distribution of pathogenic bacteria in children with chronic rhinosinusitis (CRS) and their susceptibility to commonly used antibacterial drugs .Methods 95 cases of CRS complicating adenoidal hypertrophy were per-formed adenoidectomy .The secretion of maxillary sinus ostium and posterior ethmoid sinus ostium was collected during endoscopic adenoidectomy by the disinfected cotton swab for conducting the bacterial culture and the drug sensitivity test .Results 89 speci-mens showed the bacterial growth ,the positive rate of bacterial culture in all culture specimens was 93 .7% ,86 strains of aerobic bacteria ,28 strains of anaerobic bacteria .Among 95 patients ,81 cases of aerobic infection ,52 cases of anaerobic infection ,44 cases of mixed infection .The drugs susceptibility test in vitro displayed that amoxicillin and clavulanate potassium had the higher antibacte-rial activity to aerobic bacteria and metronidazole had the higher antibacterial activity to anaerobic bacteria .Conclusion Children CRS is dominated by the aerobic bacterial infection .The bacterial infection plays a larger role in children CRS .Antibacterial drugs have better effect for treating CRS .

In the context of ongoing health reform,it is important to establish and improve the regulation system of public hospitals.By defining the concept of regulation,regulation theories for public hospitals,the regulation systems of the typical countries,the paper summarizes the international experience enlightenment to China's public hospital regulation reform.

Objective To investigate the prevalence and influencing factor of metabolic syndrome(MS)in rural elderly population. Methods With randomized cluster sampling,investigations including questionnaires,physical examination,fasting plasma glucose,blood lipids were performed in rural population aged over 60 years in Changzhou city in 2004-2005. Results A total of 4976 elderly people were enrolled in the study.The prevalence of MS was 24.1%,and 10.3%in men,34.3%in women by international diabetes federation(IDF)2005 definition.86.2%individuals had one or more of the metabolic disorders.Logistic regression analysis showed that sex,smoking,sweetmeat,family history of essential hypertension(EH)and tea drinking were influencing factors of MS. Conclusions The prevalence of MS is high in rural elderly population,especially in females.

Objective To evaluate the efficacy of nucleoside analogues (NAs) antiviral therapy on clinical outcome for hepatitis B virus (HBV)-related primary hepatic carcinoma patients after hepatectomy. Methods The clinical data of 156 HBV-related primary hepatic carcinoma patients after hepatectomy were retrospectively analyzed..According to whether accepted postoperative antiviral treatment, all patients were divided into control group (n = 80)and observation group (n = 76). The serum HBV DNA capacity, recurrence-free survival (RFS)and overall survival (OS)were compared between two groups. Results One week, 1 month, 2 months and 3 months after operation , the serum HBV DNA capacity of observation group was significantly lower than that of control group(P < 0.05). One year, 3 years and 5 years after operation, intergroup comparison of RFS rate of both groups showed statistical significance (P < 0.05) and 1 year, 3 years and 5 years after operation, the difference of OS rate of both groups indicated statistical significance (P < 0.05). Conclusion Standard NAs antiviral treatment for HBV-related primary hepatic carcinoma patients after hepatectomy ,can improve prognosis and prolong survival time. The inhibition the HBV copy active may be its mechanism.

Objective To analyze the related factors in new born failed in hearing screening and its audiological characteristics . Methods From May 2009 to Febrary 2012 ,952 infants within the 3 to 6-month-old with detailed birth records and hearing screen-ing records were reviewed in the study .They were born in Chongqing and surrounding areas ,but failed in the first and second hear-ing screening .They were tested by auditory brainstem response (ABR) ,distortion product otoacoustic emissions (DPOAE) ,tympan-ometry and stapedius reflex .Results The normal ratio of tympanogram ,normal group(74 .25% ) was higher than the high-risk group(69 .61% )(P<0 .05);The pass proportion of DPOAE in normal group(34 .57% ) was higher than high-risk group(27 .94% ) (P<0 .05);In normal group ,ABR response threshold >30 dBnHL was 55 .80% ,60 .36% in high-risk group .High-risk group′s hearing abnormality rate was significantly higher than the normal group (P<0 .05);In normal group ,mean threshold of ABR was (47 .64 ± 22 .86)dBnHL .While it was(50 .58 ± 25 .02)dBnHL in high-risk group .The threshold was higher in normal group than high-risk group(P<0 .05) .Conclusion premature birth ,low birth weight(<1 500 g) ,hyperbilirubinemia ,neonatal asphyxia ,pal-ace the virus infection ,mechanical ventilation ≥ 5 days ,≥ 2 high-risk factors are risk factors for hearing loss .Newborn hearing screening is a long and arduous task ,We should enhance screening efforts in infant with high risk factors ,and actively prevent and treat neonatal perinatal risk factors and reduce the incidence of hearing loss .

Objective To evaluate the expression of interleukin-6 (IL-6) on peripheral blood and adenoid in children with chronic rhinosinusitis (CRS) and adenoidal hypertrophy ,to investigate the mechanism of IL-6 on the occurrence and development of CRS .Methods A total of 216 cases of hypertrophic adenoids were collected ,including 95 CRS children with hypertrophic adenoid (CRS group) ,70 children with allergic rhinitis and hypertrophic adenoid (AR group)and 51 children with hypertrophic adenoid (control group) .The plasma IL-6 concentrations were detected by ELISA ,and the expression and distribution of IL-6 in adenoid tissue was detected by immunohistochemistry .Results The plasma IL-6 level in CRS group was (49 .8 ± 8 .3)pg/mL ,significantly higher than that of in control group (33 .6 ± 6 .9)pg/mL and in AR group (35 .9 ± 5 .6)pg/mL ,differences had statistic significance ( P< 0 .05) .However ,there was no statistically significant difference between AR group and control group .Meanwhile ,the presence of IL-6 in adenoid tissue was mainly seen in inflammation cells and fibroblasts while less in mesenchymal cells ,there were statistical differences between CRS group and control group/AR group (P< 0 .05) ,but no statistical difference between AP group and control group(P> 0 .05) .Conclusion Among children with CRS ,expression of IL-6 whether in peri-plasma or in focal tissue was higher than those without CRS ,demonstrating that IL-6 may play an important role in the pathogenesis and developemnt of CRS in chil-dren .

Medical educational internationalization has already made teaching medical courses in English more and more important.Nephrology department in Tongji hospital affiliated to Tongji medical college,Huazhong university of science and technology has assumed the responsibility of teaching in English for medical students of five-year program,six-year program,seven-year program,eight-year program,and abroad student for several years.They practiced teaching in English in theory teaching,PBL teaching and clinical teaching according to the characteristics and requisitions of students in different educational systems.They accumulated some experiences,which was conducive to improving the quality of teaching in English.

In order to analyze the cai]ses of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM), the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared. MM patients in our hospital were studied retrospectively. Those who referred renal impairment were divided into two groups: group I presented to nephrologists prior to MM diagnosis (n=29) and group II presented to hematologists directly (n=62). The age, sex, initial symptoms, haematological and biochemical parameters, the phenotype of paraprotein, bone marrow biopsy and cytology were undertaken and analyzed. The results showed that the median time between the initial symptoms and diagnosis in the patients of group I was longer than that in group II (P<0.001); patients in group I had significantly lower incidence of bone pain (P<0.01) and worse renal function (P<0.05) on presentation. There were lower level of myeloma cells (P<0.05), lower incidence of hypergammaglobulinemia (P<0.05), lower positive rate of monoclonal immunoglobulin (M protein) (P<0.05) and M protein level (P<0.05) in the patients of group I than those in group II. The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group I, whereas 1:0.90 in patients of group II (P<0.01). Moreover, patients with λ type had a higher degree of renal insufficiency than those with κ type (P<0.05). It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain, lower level of myeloma cells and M protein, which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type, moreover, patients with λ light chain type had a higher incidence of renal insufficiency.

AIM: To discuss the effects of phytoestrogenic-genistein on cathepsin K (CK) expression stimulated by interleukin-1α (IL-1α) in osteoclast-like cells (OCLs) . METHODS: The OCLs were isolated from tissue of human giant cell tumor of bone (GCT) . The cells treated with reagents were divided into 7 groups including control (treated with phenol red-free-DMEM), vehicle (treated with 1.2 nmol· L-1 IL- 1α), 10-10-10-6genistein, genistein+ ICI 182.780, and 17[β-estrodiol (17β-E2) group. The cells were treated with 1.2 nmol· L-1IL-1α after pre-treated with genistein or 17β-E2 for 48 h (excluded the control group) . Expression of CK wasdetermined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot in OCLs stimulated by IL-1α in the presence of genistein or 17[β-E2. RESULTS: The obvious increase of expression of CK by IL1α in vehicle group was noted in comparing with control group (P ＜ 0.01 ) . Genistein down-regulated CK gene expression stimulated by IL-1α at the transcription level in a dose-dependent manner (r = 0.68, P ＜ 0.01 ) .Genistein down-regulated CK protein expression stimulated by IL-1α also in a dose-dependent manner (r = 0.61,P ＜ 0.01 ). The effects of genistein were abrogated partly after treatment with the estrogen receptor antagonist ICI 182.780. CONCLUSION: Genistein inhibits CK expression stimulated by IL-1α partly through estrogen receptor in OCLs.

Objective To compare the therapeutic effects of early enteral nutrition and delayed enteral nutrition on severe acute pancreatitis. Methods Sixty-four patients of severe acute pancreatitis were enrolled into two groups: early enteral nutrition group was used as the treatment group and delayed enteral nutrition was used as the control group. Two weeks after the treatment, Variables of TP, ALB, CRP, APACHEⅡscore, hospital stay and recovery time of blood and urine amylase were compared between the two groups. Results The TP and ALB of the treatment group were significantly higher than those in the control group (P<0.05). The CRP and APACHEⅡscore of the treatment group were significantly lower than those in the control group (P<0.05). Compared with the control group, the recovery time of blood amylase, urine amylase and hospital stay were significantly shorter in the treatment group (P<0.05). Conclusion Using early enteral nutrition treatment in patients with severe acute pancreatitis is efficient, worthy of clinical use.