Objective: To improve the diagnosis and treatment level of secretory otitis media (SOM) of children. Method :Clinical information of 80 children with SOM were colletcted and analysed. All of the 80 cases (144 ears)were treated by myringotomy with Grommet insertion. Among them, 30 cases by adenotonsillectomy. 10 cases by palatoplasty. Secretions of 54 ears were carded out by bacterial culture. Result:80 cases were followed up for 6 to 12 mothes. 120 ears of 144 were cured (83％) ,with hearing improved. The tympanograms and hearing threshold of pure tone were found to be normal. The Gram＇s positive and negative germs of bactevial culture were 20.7％ (6/29 samples ) and 24％ (6/25 samples ) respectively. Conclusion: Children with secretory otitis media should be treated as early as posible to improve the patients＇ hearing and develope their speech.

The dark-adapted efectroretinogram (ERG) was investigated in 67 diabetic patients (124 eyes) and in 50 normal subjects (75 eyes). The results showed that the rate of reduced amplitudes and lengthened peak times of a, b waves, as well as the rate of extingaished oscillatory potentials in diabetics ERG were elevated in sequence from no, mild, moderate to severe retinopathy (P

Objective:To analyze the risk and prognostic of patients with stage ⅠB1 cervical adenocar-cinoma.Methods:The clinical data of 139 patients with stage ⅠB1 cervical adenocarcinoma treated at Department of Gynecology and Obstetrics in Peking University First Hospital from August 1994 to April 2015 were retrospectively reviewed,which included 38 cases of cervical adenocarcinoma and 101 cases of cervical squamous cell carcinoma.A comparison was made between ovarian preserving group and bilateral oophorectomy group,in order to justify the risk and prognosis of ovarian preserving patients.Results:The 5-year cumulative survival rate of stage ⅠB1 cervical adenocarcinoma and squamous cell carcinoma were 89.1% and 92.9% respectively with significant difference (P =0.034).One ovarian metastasis case was observed among the 32 cervical adenocarcinoma patients of bilateral oophorectomy,while another ovarian metastasis case was observed among 54 cervical squamous cell carcinoma patients of bila-teral oophorectomy.The ovarian metastasis rate was 3.1% (1 /32)and 1.8 % (1 /54)respectively with no statistical difference (P =0.574).The cumulative 5-year survival of 6 ovarian preserving patients with cervical adenocarcinoma was 80.1%,while that of 47 ovarian preserving patients with cervical squa-mous cell carcinoma was 94.6% (P =0.127).There was no statistical difference between the survival curve of the two groups.Conclusion:The prognosis of stageⅠB1 cervical adenocarcinomas was somewhat poorer than that of cervical squamous cell carcinoma.However it was still reasonable to perform ovarian preservation among young patients of stageⅠB1 cervical adenocarcinoma with no high risk factors.

Objective To investigate the electromyographic(EMG)characteristics of sternocleidomastoid muscle in patients with motor neuron disease.Methods The clinical and EMG data of 461 patients of MND group and 349 of non-MND group were analyzed retrospectively.Results The abnormality rate of sternocleidomastoid EMG in MND group was 60.3%,much higher than that in non-MND group(4.6%)(P

Objective To study the relationship between cleft palate and secretory otitis media(SOM)and the change of hearing of cleft palate patients with SOM before and after tube insertion.Methods 203 cleft palate patients(406 ears)were investigated by pure tone audiometry,acoustic immitance audiometry and auditory brainstem response(ABR).21 cleft palate patients with SOM underwent palatoplasty and myringotomy with tube insertion at the same time.Results The incidence of middle ear disfunction was 68.5% in 203 cases with cleft palate,which in the cases under 6 years the incidence was 80%.After operation,21 cases were followed up one to three years,their average hearing improvement was 17dB by tube insertion( P

Objective To study risk factors with the occurrence of the mesh exposure after pelvic floor reconstruction.Methods From Mar.2007 to Mar.2011,a retrospective study was made on the clinical data of 353 patients undergoing vaginal mesh pelvic floor reconstruction.The related complications of the mesh were surveyed,and risk factors associated with the mesh's exposure were studied by single factor and multiple factors logistic regression.Results It was found that the exposure rate was 9.6％ (34/353) after 1 year postoperative follow-up.Single factor analysis showed that patients who were not less than 70 years old,patients who were on their menopause stage,the occurrence of not less than three parturition,history of pelvic surgery,diabetes and smoking had a significant correlation (all P ＜ 0.05) with the occurrence of the mesh exposure after pelvic floor reconstruction.Multiple factors logistic regression analysis showed that patients who were not less than 70 years of age (OR =2.389),the occurrence of not less than three parturition (OR =2.688),the history of diabetes (OR =3.545),the history of pelvic surgery (OR =5.385) were the independent risk factors,and the operation experience was the protection factors (OR =0.134).Conclusions Mesh exposure is a common complication after pelvic floor reconstruction.Old age,multiple delivery,history of diabetes and history of pelvic surgery are the risk factors of mesh exposure.Preoperative full assessment and the quality of training contribute to reduce the incidence.

Objective To investigate the survival and prognostic factors in patients with gastrointestinal stromal tumors(GIST).Methods The histopathological slides from 153 patients with GIST were reviewed. The expression of CDllT,CD34,platelet-derived growth factor receptor alpha (PDGFR-a) and Ki-67 proteins were measured by immunohistochemical staining. The factors thatinvolved in the survival and prognosis were analyzed based on the clinical features and GIST biological behavior ranking.The Kaplan-Meier and Cox model were used to evaluate the effect of variant factors on survival and prognosis.Results The survival rate of 135 patients was 94.1% 76.3% and 65.9% at 1,3 and 5 years,respectively.On univariate analysis survival was predicted by tumor size (χ2= 40.565,P＜0.01),primary tumor location (χ2=13.245,P＜0.01),mitotic count (χ2= 22.626,P＜0.01),risk ranking (χ2=19.186,P＜0.01),necrosis (χ2==28.665,P＜0.01),incomplete resection χ2=2 =29.110,P＜0.01) and Ki-67 index (χ2=15.953,P＜0.01).Multivariate analysis demonstrated that thetumor size ＞ 10 cm,primary tumor location,mitotic count＞ 10/50 HPF,high risk subgroup,tumor necrosis and Ki 67 index ＞ 5 % were poor predictors of survival.Ki-67,tumor size and mitotic count were strong poor predictors of survival.Conclusions Fletcher's biological behavior ranking is a good approach to predict prognosis of GIST patients and has significant clinical value.It's better to combine itwith other factors such as Ki-67 index and primary tumor location in order to provide evidence for therapy.

Objective To investigate the expression of interleukin (IL)-34/colony stimulating factor(CSF)-1R in the process of transforming growth factor ( TGF)-β1 inducing epithelial-mesenchymal transition ( EMT) of human alveolar epithelial cells A549 cells.Methods A549 cells were cultured in vitro.CCK 8 was used to test the influence of the proliferative rate of A549 cells which were stimulated by TGF-β1 at different concentrations and time points .A549 cells were stimulated by 5μg/L TGF-β1 at 0 hour, the 12th hour, the 24th hour, and the 48th hour.Western blotting was adopted to detect changes of the following proteins: α-smooth muscle actin (α-SMA ) , E-cadherin ( E-Cad ) , matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1). Real-time PCR was adopted to detect changes of the following genes: IL-34 mRNA, CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA.Results TGF-β1 had no significant influence in the proliferation of A 549 cells compared with the control group(P>0.05).TGF-β1(5μg/L)stimulated A549 cells at different time point (0 hour, 12, 24, 48 hours), compared with the control group .The epithelial phenotype E-Cad protein was gradually down-regulated ( P <0.01 ) , while the mesenchymal phenotype α-SMA protein was gradually up-regulated ( P <0.01 ) and the protein of MMP-2 increased gradually (P<0.01).The protein of MMP-9 increased firstly and then was reduced (P<0.01),the peak was at the 24th hour.The protein of TIMP-1 was firstly transiently increased and then reduced (P<0.01), the minimum was at the 48th hour.Compared with the control group , the gene of IL-34 mRNA increased gradually (P<0.01), and the genes of CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA increased firstly and then decreased ( P <0.01), which were peaked respectively at the 24th hour, the 24th hour, the 12th hour, respectively.Conclusion In the process of TGF-β1 inducing A549 cells transition,there is accompanied with the expression of IL-34/CSF-1R.

Objective:To analyze the prognosis-related factors of ovarian serous adenocarcinoma in order to set up a prognostic model of serous adenocarcinoma and verify the effectiveness of the model as prognostic clinical criteria.Methods:The clinical, patholo-gical and follow-up data from 181 training samples with ovarian serous adenocarcinoma in Peking University First Hospital during January 1995 to December 2003 and another 42 detection samples with ovarian serous adenocarcinoma in Beijing Cancer Hospital during January 1999 to December 2005 were analyzed retrospectively. Kaplan-Meier univariate analysis was used to screen out prognostic factors; COX univariate and multivariate analyses were used to determine the risk coefficient of each factor and different layers in each factor; Pearson rank correlation analysis was used to identify the correlation of each factor. The prognostic model of ovarian serous adenocarcinoma was established on the conversion of risk coefficient to prognostic score and receiver operating characteristic (ROC) analysis was used to determine the cut-off value. The clinical data were collected to verify the sensitivity and specificity of the prognostic model based on the 3-year survival rate and Ki67 value.Results:The survival rate of patients with ovarian serous adenocarcinoma correlated with 6 factors including FIGO stage, histological grade, residual size, metastasis of lymph nodes, general condition after chemotherapy, and serum CA125 levels. The postoperative chemotherapy was an independent factor for prognosis. The prognostic model directly reflected the survival probability of classical COX risk ratio model, with higher score indicating lower survival probability and poorer prognosis. If combining prognostic score with Ki67 the sensitivity and specificity reached 64.7% and 96.0%, respectively.Conclusion:FIGO stage, histological grade, residual size, metastasis of lymph nodes, postoperative chemotherapy and serum CA125 were the prognostic factors of patients with ovarian serous adenocarcinoma. The prognostic model of ovarian serous adenocarcinoma can moderately reflect the actual survival status, and combination with Ki67 will increase the sensitivity and specificity.

Objective To explore the treatment effect of peripherally inserted central catheter (PICC) in parenteral nutrition of infants and observation and nursing of its complication.Methods Clinical data of 32 cases of infants who underwent parenteral nutrition through PICC were analyzed.The nursing experience and observation and handling of common nursing problems were summarized.Results 2 cases failed catheterization,the others succeeded,1 case through scalp,2 cases through axillary,27 cases through basilic vein.2 cases completed TPN treatment with a second try of PICC.The shortest indwelling time of PICC was 3 days,the longest was 34 days.Catheter blockage happened in 1 case,leakage in 1 case,and catheter-related infections in 1 case.Conclusions Difficulty exists in application of PICC in infants,but the complications were less.The tube can be retained for a long time,which conforms to higher intravenous nutrition requirement of infants,and this method possesses wide application perspective.