Objective To investigate the application of ear endoscope in the treatment of secretory otitis media in children with ineffective drug therapy.Methods 80 secretory otitis media children with ineffective drug therapy were selected as the research subjects.According to the random number table method,all patients were divided into treatment group and control group,40 cases in each group.The observation group received otoendoscopic tympanic membrane tube surgery treatment,the control group received auripucture with otic endoscope surgery treatment.The complications of the two groups were observed,and the clinical curative effect and postoperative recurrence were compared.Results The recurrence rate of the observation group was 5 .00%,which was significantly lower than 20.00% of the control group (χ2 =4.114,P=0.042).The middle ear effusion time of the observation group was (8.53 ±1.25)d,which was significantly shorter than (10.46 ±1.44)d of the control group (t=5.074,P=0.000). In the observation group,37 patients after treatment had change,the total effective rate was 92.50%.In the control group,28 patients after treatment had change,the total effective rate was 70.00%,the total effective rate of the observation group was significantly higher than the control group,the difference was statistically significant (χ2 =6.646,P=0.009).The incidence rate of complication in the observation group was 7.50%,which was significantly lower than 32.50% in the control group (χ2 =7.812,P=0.005 ).Conclusion Tympanostomy tube under ear endoscope surgery for the treatment of drug refractory secretory otitis media in children has good effect,the recurrence rate is relatively lower,has less complications,high safety,it is worthy of clinical application.

The ZHENG (syndrome of traditional Chinese medicine) oriented effects and the multiple-targets' mechanism are the main challenges encountered by recent researches for Chinese herbal formula. Using methods of bioinformatics and systems biology, we proposed a biological network-based framework for understanding the mechanism of Chinese herbal formula, and reviewed our studies under this framework which aimed to explore the relationship between Chinese herbal formula and corresponding ZHENGs, as well as the synergism of herbal combinations. These studies include the network construction for cold or heat ZHENG and its relationship with herbal formula of hot or cold nature, the biological network construction of angiogenesis, and the network regulation-based emergent property of an herbal combination with anti-angiogenesis synergism extracting from the cold formula. It is shown that the ZHENG-oriented effects and the herbal synergism can be nicely explicated by such network-based approaches. Thus, the network-based drug combination discovery, as well as the "traditional Chinese medicine bioinformatics (TCMB)" and "TCM computational systems biology" combining with computational and experimental approaches, is conceivable and can open a new avenue for understanding Chinese herbal formula.

Background and purpose:Cyclooxysenase-2(COX-2)was first researched in colon caner,and extensively studied in breast cancer.However it was rarely reported in lymph node negative breast cancer.This study assessed the effect of expression of COX-2 in the prognosis of lymph node negative breast cancer and its use as information of COX-2 status to perfect the prognostic mathematic model.Methods:The expression of COX-2 protein was detected by IHC in 119 cases of lymph node negative breast cancer,the survival data was analyzed.Results:Elevated expression of COX-2 was associated with unfavorable distant disease-free survival(74% vs 93.86%).In subgroups by the simple prognostic model PI=size+HER2-2.5?age-CT-0.55?(ER?ET),the 5-year DFS were decreased with subgroups of low-risk,mid-risk and high-risk and the rate of elevated expression of COX-2 was increased with higher risk subgroups.Furthermore,in mid-risk group,the elevated expression of COX-2 was still able to predict poorer prognosis.Conclusion:The information of expression of COX-2 can be used to perfect the simple prognostic mathematic model,thus it would be more effective for treatment of breast cancer with auxiliary lymph nodes metastases.

Pregnancy associated breast cancer(PABC) is a special kind of breast cancer,it is difficult to diagnose at early stage since the mammary epithelial cells are actively proliferative.Whether pregnancy will affect the biological behavior of breast cancer and how the treatment strategy for the patients with PABC impact on the outcome in terms of side effects,response,etc,those factors have to be taken into special consideration.The standard management of PABC still remain controversial.This article summarized the studies on PABC and discusses the advances in the management of the disease.

Meningococcal disease,caused by Neisseria meningitidis (Nm),is still one serious threatening infectious disease with high mortality.Vaccination is available for prevention and control of such disease.Based on the chemical structure of capsule polysaccharide,Nm strains were classified into 13 serogroups.Meningococcal polysaccharide vaccines and polysaccharide conjugated protein vaccine against serogroup A,C,W 135 and Y were efficacious and have been widely used.Because of poor immunogenicity and the structurally homologous with neural cell,capsule polysaccharide of serogroup B Nm can not be used as vaccine candidate.In last several decades,B group vaccines develoment focused on the proteins research.Based on the out membrane protein and reverse vaccinology technology,progress of B group vaccine were accelerated.Several meningococcal B vaccine showed favorable immunogenicity and efficacity.Some B vaccines have been licensed and widely used.

Objective To investigate the clinical characteristics of nosocomial infections in senile inpatients(≥75 years old) and to propose the control strategy according to the analysis. Methods A total of 2675 senile inpatients(≥75 years old) from 2007 to 2008 were prospectively evaluated and retrospectively reviewed. The infection incidence rate, infection fatality rate, average length of stay in hospitals, location of infections, main pathogenic bacteria and common protopathy were analyzed. Results Among 2675 senile inpatients, 222 senile inpatients suffered from nosocomial infection. Among all age groups in this hospital during the same period, the infection incidence rate and the infection fatality rate were higher in the senile group than in the general group(8.3% vs. 1.9%, 0.8% vs. 0.1%,both P<0.01). The average length of stay in our hospital was 54.0 days. The lower respiratory tract infections were most common, and the urinary system infections, and the blood infections. Gram-negative bacteria was the major source of nosocomial infection(47.0%, 110/234), while infection rate of Gram-positive bacteria was 32.9% (77/234) and fungus was 20.1% (47/234). The cerebral vascular disease was the most common protopathy, then malignant tumor was in 45 cases (20.3%), kidney disease was in 31 cases(14.0%), cardiac disease was in 29 cases(13.1%) and respiratory disease was in 21 cases(9.5%). Conclusions There are higher infection incidence rate, higher infection fatality rates,longer length of stay in hospitals in senile inpatients(≥75 years old). The lower respiratory tract infections were most common and Gram-negative bacteria was the major source of nosocomial infection. We should adopt active management to control the nosocomial infections.

An increasing numaber of clinical trials have confimed the cholesterol-independent effects of statins.Recent clinical observations have found that using statins before the onset of ischemic stroke and during the acute stage can greatly lessen the severity of neurological defi-cits,reduce the mortality,and improve the prognosis;and that for patients with long-term statius treatmem,who withdraw the drug abruptly,may aggravate stroke lesions,and increase the risk of relapse.Although the use of statius may slightly increase the risk of bleeding,undoubtedly,the use of statins has become one of the most important approaches in the prevention and treatment of ischemic stroke.

Objective To observe the influence of bacterial lysates (broncho-vaxom) combined with montelukast sodium on serum immunoglobulin, interferon (IFN)-γ and interleukin (IL)-4 in asthma and the clinical efficacy. Methods Thirty-one patients with asthma in acute period of onset in children (study group) received broncho-vaxom combined with montelukast sodium for 3 months on the basis of conventional treatment. The changes of serum IgG, IgA, IgM, IFN-γ and IL-4 levels before and after treatment were observed and compared with 31 healthy children (control group), the score changes of day and night symptom were also observed before and after treatment. Results IgG and IgA levels were abnormal significantly in study group before treatment (P < 0.05 ), they were significantly increased after treatment, but IgG was still significantly lower than that in control group (P < 0.05 ). IFN-γ and IL-4 were significantly abnormal in study group before treatment (P < 0.05), IFN-γ was significantly increased after treatment (P<0.05), while IL-4 was significantly decreased (P<0.05); after 3 months of treatment, the score of day and night symptom in study group were (0.4±0.1 ) and (0.7±0.2) scores respectively, which both decreased significantly than those before treatment [(2.6±0.3 ) and (3.4±0.7) scores respectively],the difference were statistically significant(P < 0.05 ). Conclusion Children with asthma have the existence of decreased immune function, application of broncho-vaxom combined with montelukast sodium can effectively control its symptoms and improve immune status.

Objective To realize information management in the clinical treatment process and provide efficient services for patient. Methods From the requirement of the First Clinical College of Harbin Medical University, construction of digital clinical system was thoroughly elaborated. The functions and characters of the system were summarized. The application effect of the system was expatiated. Results The application of the system realized the whole network management for medical care, charging and pharmacy, thus optimizing the medical treatment process. Conclusion The management level and work efficiency are enhanced.

Objective:Through reading a lot of literature on the critical path planning of FDA, analyzed the contribution and shortage of the critical path plan to China's medical device market access system.Methods: To analyze the critical path planning of FDA by using the method of literature review.Results: China should reference the critical path plan, reform the existing medical instrument market access system, improve the efficiency, simplify the procedure and promote the safety and development of the product.Conclusion: The research on the critical path planning of FDA is very important for the construction of China's modern medical device market access path.