OBJECTIVE:To compare the effects of prophylactic application of 3 different antibiotics on prognosis in patients underwent breast lesion resection. METHODS:1 066 patients with breast lasion resection from 12 hospitals of Shaanxi province were divided into trial group(360 cases),control group A(352 cases)and control group B(354 cases)according to random num-ber table. Trial group was given first generation cephalosporin cefazolin;control group A was given second generation cephalospo-rin cefuroxime;control group B was given third generation cephalosporin cefoperazone sodium and tazobactam sodium. The dosage regimens of 3 groups were as follows:relevant drug 2 g added into 0.9%Sodium chloride injection 100 ml,ivgtt,0.5 h before sur-gery,medication course≤24 h after surgery in trial group. Those indexes of 3 groups were observed,such as post-operative ADR, incision healing,infection,hospitalization duration,phamaceutical costs per capita. RESULTS:There was no statistical signifi-cance in the rate of incision healing and the rate of post-operative infection among 3 groups(P>0.05). The incidence of post-opera-tive ADR,hospitalization duration and phamaceutical costs per capita in observation group were significantly lower or shorter than in control group A and B,with statistical significance(P<0.05). CONCLUSIONS:Cefazolin is better than cefuroxime and cefo-perazone sodium and tazobactam sodium to reduce the postoperative adverse reaction,antibiotics cost per capita and hospital drug cost per capita,shorten the hospitalization duration.

Objective To investigate the related factors of speech intelligibility in the prelingually deafened children after cochlear implantation. Methods 47 prelingually deafened children who had received cochlear implantation and their families were investigated with questionnaires and analyzed with Fisher test. Results The age when cochlea implanted, the age when hearing aided, the time after the cochlear implantation and the time the cochlea opened were related with their speech intelligibility rating. Conclusion Suitable time for implantation, the hearing aid and making reasonable rehabilitation programme play a crucial role in the hearing rehabilitation of prelingually deafened children after cochlear implantation.

OBJECTIVE: To investigate the clinical experiences and access the auditory performance and speech intelligibility of cochlear implantees with inner ear malformations. METHOD: A retrospective study was performed on the surgical characteristics and the mapping characteristics after implantation of patients who received mult-channel cochlear implantation from 2000 to 2007 in Xijing Hospital. Matched with normal implanted, rank -sum test was performed to compare scores of categories of auditory performance (CAP) and speech intelligibility rating(SIR). RESULT: After the regular rehabilitation, the long term follow-up of the auditory performance and speech intelligibility were very positive. There was no significant difference between normal group and malformations group. CONCLUSION The cochlear implantation can be performed safely in patients with malformed inner ear. The results suggest that cochlear implantation could also provide long-term benefits to those malformed inner ear cases.
Child ; Child, Preschool ; Cochlea ; abnormalities ; surgery ; Cochlear Implantation ; rehabilitation ; Cochlear Implants ; Deafness ; rehabilitation ; surgery ; Ear, Inner ; abnormalities ; surgery ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Speech Perception ; Surveys and Questionnaires ; Treatment Outcome

Objective: To explore the value of magnetic resonance imaging (MRI)-based whole tumor texture analysis in differentiating borderline epithelial ovarian tumors (BEOTs) from FIGO stage I/II malignant epithelial ovarian tumors (MEOTs). Materials and Methods: A total of 88 patients with histopathologically confirmed ovarian epithelial tumors after surgical resection, including 30 BEOT and 58 MEOT patients, were divided into a training group (n = 62) and a test group (n = 26).The clinical and conventional MRI features were retrospectively reviewed. The texture features of tumors, based on T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging, were extracted using MaZda software and the three top weighted texture features were selected by using the Random Forest algorithm. A non-texture logistic regression model in the training group was built to include those clinical and conventional MRI variables with p value < 0.10. Subsequently, a combined model integrating non-texture information and texture features was built for the training group. The model, evaluated using patients in the training group, was then applied to patients in the test group. Finally, receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of the models. Results: The combined model showed superior performance in categorizing BEOTs and MEOTs (sensitivity, 92.5%; specificity, 86.4%; accuracy, 90.3%; area under the ROC curve [AUC], 0.962) than the non-texture model (sensitivity, 78.3%; specificity, 84.6%; accuracy, 82.3%; AUC, 0.818). The AUCs were statistically different (p value = 0.038). In the test group, the AUCs, sensitivity, specificity, and accuracy were 0.840, 73.3%, 90.1%, and 80.8% when the non-texture model was used and 0.896, 75.0%, 94.0%, and 88.5% when the combined model was used. Conclusion MRI-based texture features combined with clinical and conventional MRI features may assist in differentitating between BEOT and FIGO stage I/II MEOT patients.

Objective To investigate the implementation effect of the situation-background-assessment-recommendation (SBAR) communication mode in hospital surgical teams from the elaborate perspective. Methods Since 2015, the surgical teams of Wuxi No.2 People's Hospital, Affiliated to Nanjing Medical University combined the elaborate management with the SBAR communication mode. The elaborate SBAR report mode was established in the surgeries. Security check reports were carried out in the surgeries. The quality of the nurses' shifting of duty, the incidence of adverse events and the satisfaction of patients after the implementation of the mode were compared to before the implementation.Results The time of the nurses' shifting of duty was shortened from (13.1±4.5)min to(7.4±2.1)min significantly (t=10.737,P<0.01). The incidence of adverse events due to poor communication decreased from 50% to 13.33% significantly (χ2=4.950,P<0.05). The patients' satisfaction on the work of operating rooms increased from 84.44% to 95.74% significantly (χ2=6.652, P<0.05).Conclusions The implementation of the hospital surgical team SBAR communication mode in operating rooms from the elaborate perspective effectively upgrades the meaning of specialist care, optimizes the service procedure and reduces the incidence of adverse events due to poor communication, which guarantees the safety of surgical patients.

Objective To explore the effect of thymic stromal lymphopoietin (TSLP) on transformation of dendritic cell (DC) and T cell in vitro.Methods Mouse-derived immature dendritic cells and T lymphocytes were co-cultured in vitro,which were divided into 4 groups (TSLP stimulation group,TSLP stimulation and its receptor blocking group,ovalbumin stimulation group and ovalbumin stimulation and TSLP receptor blocking group).IL-4,IL-8 and IFN-β in cell culture supernatant were detected after 2 days by ELISA.SPSS 13.0 software was used to analyze the data.Results IL-4 levels of TSLP receptor blocking groups [(48.84 ± 1.56) pg/ml,(52.53 ± 2.36) pg/ml] were significantly lower than those of corresponding TSLP stimulation group and ovalbumin stimulation group [(72.55 ± 7.76) pg/ml,(80.47 ± 21.93) pg/ml ; t =5.994,P ＜ 0.05 ; t =2.534,P ＜ 0.05].However,there were not significant differences of IL-8 and IFN-β expression between corresponding two groups of whether or not TSLP receptor blocking (all P ＞ 0.05).Conclusion TSLP receptor blockade in vitro can inhibit T lymphocyte transformation to Th2,which may provide a new therapeutic strategy for clinical Th2 dominant diseases such as allergic rhinitis and asthma.

Objective:To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs).Methods:Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis.Results:In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna′s classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence.Conclusions:There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna′s classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.

PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550
Age Distribution ; Asian Continental Ancestry Group ; Asthma ; Capsaicin ; China ; Cough ; Female ; Healthy Volunteers ; Humans ; Male ; Reflex ; Sex Distribution

Digital intraoral scanning is a hot topic in the field of oral digital technology.In recent years,digital intra-oral scanning has gradually become the mainstream technology in orthodontics,prosthodontics,and implant dentistry.The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression.However,the operators are less familiar with the intraoral scanning characteristics,imaging process-ing,operator scanning method,oral tissue specificity of the scanned object,and restoration design.Thus far,no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad.To deal with the problems encountered in oral scanning and improve the quality of digital scanning,we collected common expert opin-ions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence.We also describe the scanning strategies under different oral impression requirements.The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images,adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy.The scanning trajec-tories mainly include the E-shaped,segmented,and S-shaped methods.When performing fixed denture restoration,it is recommended to first scan the abutment and adjacent teeth.When performing fixed denture restoration,it is recommend-ed to scan the abutment and adjacent teeth first.Then the cavity in the abutment area is excavated.Lastly,the cavity gap was scanned after completing the abutment preparation.This method not only meets clinical needs but also achieves the most reliable accuracy.When performing full denture restoration in edentulous jaws,setting markers on the mucosal tissue at the bottom of the alveolar ridge,simultaneously capturing images of the vestibular area,using different types of scanning paths such as Z-shaped,S-shaped,buccal-palatal and palatal-buccal pathways,segmented scanning of dental arches,and other strategies can reduce scanning errors and improve image stitching and overlap.For implant restora-tion,when a single crown restoration is supported by implants and a small span upper structure restoration,it is recom-mended to first pre-scan the required dental arch.Then the cavity in the abutment area is excavated.Lastly,scanning the cavity gap after installing the implant scanning rod.When repairing a bone level implant crown,an improved indi-rect scanning method can be used.The scanning process includes three steps:First,the temporary restoration,adjacent teeth,and gingival tissue in the mouth are scanned;second,the entire dental arch is scanned after installing a standard scanning rod on the implant;and third,the temporary restoration outside the mouth is scanned to obtain the three-di-mensional shape of the gingival contour of the implant neck,thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration.For dental implant fixed bridge repair with missing teeth,the mobility of the mucosa increases the difficulty of scanning,making it difficult for scanners to distinguish scanning rods of the same shape and size,which can easily cause image stacking errors.Higher accuracy of digital implant impres-sions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius.The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases,the scanning accuracy decreases accordingly,especially when performing full mouth implant restoration impressions.The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal mor-phology inside the mouth and the lack of relatively obvious and fixed reference objects,which results in insufficient ac-curacy.When designing restorations of this type,it is advisable to carefully choose digital intraoral scanning methods to obtain model data.It is not recommended to use digital impressions when there are more than five missing teeth.

Even though a large amount of researches showing the clinical effectiveness of acupuncture, there are the researches indicating the absent difference between acupuncture and sham-acupuncture (placebo), which provides the doubts on the specificity of acupuncture. It may be considered that acupuncture intervention is complica-ted and may produce unique non-specific effect, which results in the failure to evaluate effectively the acupuncture efficacy. The influential factors of the non-specific effect of acupuncture include the interaction between physician and patient, expectancy, physician authority, acupuncture treatment experiences, etc. It may be also relevant with the anticipated biological effect, Hawthorne effect, Pavlovian conditioned reflex, etc.