Objective To evaluate the common causes of chronic cough and the diagnostic value of clinical symptoms,and provide evidences for empirical treatment.Methods The causes of patients with chronic cough were evaluated by a validated systematic diagnostic protocol.The characteristics of the cough timing,characters,incentives and associated manifestations of chronic cough with different causes were compared.Results A total of 160 patients with at least 8 weeks of chronic cough and normal chest radiographswere recruited from the Department of respiratory diseases of Yichang Central Hospital between Jan.to Dec.2009.The most common causes of chronic cough were cough variant asthma (CVA,n =72,45％ ),upper airway cough syndrome ( UACS,n =54,33.75％ ),eosinophilic bronchitis ( EB,n =14,8.75％ ),gastroesophageal reflux-related chronic cough ( GERC,n =9,5.63％ ),other etiologies ( n =11,6.87％ ).Significant differences were observed in different etiological subtypes.The incidence of nocturnal cough in CVA was 52.8％ ( 38/72 ),significantly higher than others types ; URCS patients manifested more day coughs,with 70.2％ postnasal drip syndrome and significantly more cases had the history of nasal diseases compared with other types.The specificity of cough associated with meals in GERC were 66.7％,and the regurgitation associated symptom in GERC were77.8％,significantly higher than other types.However no special syndromes were observed in EB patients.Conclusion All kinds of chronic coughs have specific symptoms.The spectrum of causes and clinical features of chronic cough are important in the diagnostic procedure of chronic cough.

Objective To investigate the clinical effect of the treatment of acute radiation dermatitis caused by radiotherapy in nasopharyngeal carcinoma patients treated with hydrogen. Methods Selected from January 2014 to January 2016 for nasopharyngeal carcinoma in the first hospital of Ningbo radiotherapy lead to acute radiation dermatitis patients were studied, by drawing lots method were divided into treatment group and control group with 40 cases in each. The patients in the control group were given conventional treatment, iodine inunction, treatment group given routine treatment, hydrogen card grease rubbed. Comparison of two groups of treatment effect. Results After 10 days of treatment, the treatment group the score RISRAS significantly lower than the control group (P < 0.05). Conclusion Combination of hydrogen and conventional therapy in the treatment of acute radiation dermatitis induced by radiotherapy in nasopharyngeal carcinoma patients, can significantly shorten the treatment time.

BACKGROUND:After different metal fixation materials areimplanted into the human body, peripheral tissue inflammatory response to varying degrees wil appear in the early stage. Poor biocompatibility of the corresponding materials wil lead to prolonged duration of inflammatory reaction.
OBJECTIVE:To investigate the inflammatory factor level changes and biocompatibility of cancelous bone screw fixation in treatment of unstable pelvic fractures.
METHODS:A total of 61 patients with unstable pelvic fractures were randomly divided into the observation group (29cases) and the control group (32 cases). The 29 patients in the observation group underwent cancelous bone screw fixation. The 32 patients in the control group underwent conventional therapy. During 12 months of folow-up, Majeed function score and inflammatory factor level changes and adverse events were observed and compared between the two groups.
RESULTS AND CONCLUSION:(1) Majeed function scores were significantly higher in both groups after treatment as compared with that preoperatively (alP< 0.05). The Majeed function scores were significantly higher in the observation group than in the control group 12 months after treatment (P< 0.05). (2) Inflammatory factor levels: Interleukin 6, C-reactive protein, and tumor necrosis factor alpha levels were significantly lower in both groups after treatment as compared with that preoperatively (alP< 0.05). No significant difference in above indexes was found between the two groups before and after treatment (P> 0.05). (3) Adverse events: one case affected incision infection after operation in the observation group. In the control group, four patients experienced incision infection. One suffered from nonunion, and one had bone necrosis. Above patients were treated in time, and were cured, so there wereno deaths. There were significant differences in the incidence of adverse events between the 2 groups (P< 0.05). (4) The research results show that cancelous bone screw fixation for unstable pelvic fractures can obtain satisfactory clinical results, andhave good biocompatibility.

Objective To investigate the influence of iloprost on the expression of lung endothelin-1(ET-1) in rats with hypoxic pulmonary hypertension(HPH).Methods Thirty-two male SD rats were randomly divided into four groups:normal control (NC) group,normal treatment(NT) group,hypoxia control(HC) group,hypoxia treatment (HT) group.NC group and NT group raised under normal Oxygen conditions 3 weeks.HC and HT group placed in a low Oxygen chamber (O2 10％) were treated 3 weeks of hypoxia 8 hours per day.NT and HT group were treated daily iloprost by inhalation therapy (2μg/kg).Affer three weeks,measured mean pulmonary arterial pressure (mPAP),right ventricular systolic pressure (RVSP),index of right ventricular hypertrophy.HE staining was used to observe the morphological changes of pulmonary arteries and image analysis system was used to calculate the percentage of vascular wall thickness of small pulmonary arteries in each group,RT-PCR technique was used to assess the trends of ET-1 in lung tissue homogenates.Results The hemodynamics in HC group was significantly higher than other groups(P＜0.05),there was no significant statistically difference of the hemodynamics in HT group compare with normal control group.Pulmonary arteries morphology,vessel wall thickening and vessel lumina stenosis in HC group than NC、NT、group.These indicators were significant improved in HT group.ET-1 expression in lung tissue were significantly increased in HC group than NC groups.No significant difference was found between and NC group HT group.Conclusion Aerosol inhalation of iloprost has exact therapeutic effect for rats with HPH.Iloprost reduced ET-1 overexpression in lung tissue in HPH rats and prevent pulmonary vascular remodeling.

Objective To evaluate the efficacy of hypofractionated 3DCRT for primary liver cancer(PLC) with portal vein tumor thrombosis(PVTT).Methods Between April 1999 and August 2003,34 PLC patients with PVTT received hypofractionated 3DCRT.The severity of hepatic cirrhosis was 23 in Child-Pugh gradeA and 11 gradeB.The median value of GTV was 773?cm~3(105-2097?cm~3).The radiotherapy regimen consisted of 38-63?Gy in 7-15 fractions with 4-8?Gy per fraction(median value 5?Gy),the treatment was delivered 3 times per week during every other day.Results Having response rate(CR+PR) of 76%(26/34),the overall 1-,2-,and 3-year survival rate at was 36%,19% and 13%,respectively.Conclusion Hypofractionated three-dimensional conformal radiotherapy is effective for primary liver cancer with portal vein tumor thrombosis.

Objectives To explore the effects of aging on midgastric transverse band(MTB)and gastric emptying.Methods In our prospective study,57 healthy volunteer were divided into young, middle and old-age groups.After taking test meal labeled by 99mTc-iethylenetriaminepentaacetic acid(99mTc-DTPA), the pictures were collected using double probe single photon emission computed tomography(SPECT).Stomach in each frame of the pictures was divided into proximal, midgastric transverse band(MTB)and distal parts.And half gastric emptying time,gastric remnant rate at 90 min, areas of different gastric parts were tested and calculated respectively.Results Half gastric emptying time of whole stomach was(43.24± 11.87)min,(42.07 ± + 9.31)min and(45.81 ± 10.73)min in young,middle and old-age groups, respectively, with P＞0.05.Among young, middle and oldage groups, half gastric emptying time was(38.09 ± 10.26)min,(37.33 ± 9.28)min and(26.74 ± 12.07)min in proximal stomach, and it was(38.35 ± 12.96)min,(37.73 ± 7.46)min and(46.41 ± 10.74)min in distal stomach,respectively.The half gastric emptying time was significantly reduced in proximal stomach and increased in distal stomach in old-age group(both P＜0.05).The gastric nuclide remnant rate at 90min in total stomach was(30.38 ± 19.32)％,(29.03 ± 10.36)％ and(31.92 ± 13.47)％ ,in young, middle and old-age groups, respectively, with P＞0.05.This rate in proximal stomach was(25.01 ± 12.35)％,(26.36± 15.29)％ and(19.54±8.47)％ among three group, respectively.The rate in proximal stomach was(42.25 ± 12.36)％,(41.56 ±± 9.33)％ and(56.05 ± 11.72)％ among three group,respectively.The gastric remnant rate at 90min was reduced in proximal stomach and was increased in distal stomach significantly in old-age group(both P＜0.05).Compared with young and middle-age group,the old-age group showed no difference in areas of total stomach in all the time, while the areas were reduced in proximal stomach and increased in distal stomach significantly from 30 min to 90 min(all P＜0.05).Total stomach versus proximal and distal stomach showed no difference in count/pixel ratio in all time,while a count/pixel ratio was reduced in proximal stomach and increased in distal stomach significantly from 30 min to 90 min(both P＜ 0.05).Both areas and count/pixel ratio of MTB at 60 min and 90 min were significantly increased in old-age group(both P＜0.05).Conclusions The total gastric emptying is not delayed along with aging, while the gastric emptying is increased in proximal stomach and reduced in distal stomach in the elderly.This abnormity of intragastric distribution of food might be related with larger area of midgastric transverse band.

Adult ; Endoscopy ; Ethmoid Sinus ; surgery ; Humans ; Lipoma ; surgery ; Male ; Orbital Neoplasms ; surgery ; Paranasal Sinus Neoplasms ; surgery

OBJECTIVE Through researching the ABR threshold, the cochlear morphology and miR-96 expression in the cochlear of BALB/c mice at different month's age, to find out if the miR-96 can regulate the age related hearing loss of BALB/c mice.METHODS ABR testing, AO/PI staining and scanning electron microscope were used to observe the ABR threshold and cochlear morphology of the BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months. Real-time PCR was used to detect the expression of miR-96 in the cochlea of BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months.RESULTS The ABR thresholds of BALB/c mice were (18.5±8.3), (45.8±7.8), and (85.6±15.6) dB SPL separately at the age of 3, 6 and 12 months. At the age of 18 months, no response was observed in the ABR testing with 120 dB SPL acoustic stimulation. In the AO/PI staining, we found that the outer hair cells was apparently lost since the age of 6 months and the loss of hair cells aggravated as the month's age increased. At the age of 12 months, no outer hair cells was left, inner hair cells was lost apparently too. With the scanning electron microscope, we found the changes of deficiency, lodging, fusion, shortening and inversion in the hair cell cilia. And these changes were aggravated as the month's ages increased. At the age of 3 months, the relative expression of miR-96 (2-△CT) was 0.0225±0.0073. The relative expression of miR-96 (2-△CT) in the cochlea were 0.0162±0.0048, 0.0116±0.0048, and 0.0050±0.0014 at the age of 6 months, 12 months and 18 months separately, comparing with the relative expression of miR-96 at the age of 3 months, the differences were significant(P<0.05).CONCLUSION The hearing loss, hair cells loss, and cilia damage aggravated as the month's age increased, but the miR-96 expression in the cochlea decreased. Which suggest that miR-96 might play an important role in the age related hearing loss.

Objective To analyze the prevalence status and the genetic characterizations of influenza B viruses isolated in Hunan Province after pandemic influenza A (H1N1) 2009,and to explore possible reasons for the prevalence.MethodsThroat swabs were collected from outpatients with influenza-like illness in 23 sentinel hospitals of Hunan Province in 2010.Influenza viruses were isolated with Madin-Darby canine kidney (MDCK) cells and identified by haemagglutination inhibition test.The genomes of 10 selected influenza B viruses were sequenced and analyzed for phylogenetic and molecular characterization.ResultsWith the reduction of isolation of pandemic influenza A (H1N1)2009 viruses,influenza B virus became the predominant isolated strain in the first half of 2010.Epidemic viruses mainly belonged to the B/Victoria lineage,and both two lineages co-circulated.Seven out of 11 influenza outbreaks caused by type B.Ten strains were filled into 2 branches of BV and BY which were classified by their lineage types in polymerase (PB2,PB1,PA),hemagglutinin (HA),neuraminidase (NA),NB,membrane protein (M1),influenza B virus membrane protein M2 (BM2),and non-structural protein (NS1,NS2) phylogenetic trees except the NP phylogenetic tree in which 10 strains were all in the BY branch.Compared with World Health Organization (WHO) vaccine strains,the amino acid identity of 11 proteins of the 10 strains was high (97.2％-100.0％).However,some amino acid point mutations were found.No mutation was found in drug resistance mutation sites.Some mutations in NA,NB,PB1,PB2 and NS2 molecules were found in 2 strains isolated from outbreaks compared with strains from sentinel surveillance.Conclusions The point mutations,insertions and genetic reassortment indicate viruses sustaining evolution,which is probably the reason for predominant influenza B viruses after pandemic influenza A (H1N1) 2009 in Hunan Province.

OBJECTIVE To investigate a better surgical treatment for chronic otitis media.METHODS 106 patients with chronic otitis media were collected from hospital. We assessed effectss of ossicular chain reconstruction without incision of mastoid (method 1) and ossicular chain reconstruction with incision of mastoid (method 2).We compared therapeutic effect, complication, and surgical treatment between these two groups. Furthermore, we performed stratification analysis by normal or abnormal function of stapes, Eustachian and tendon of tensor tympani, using logistic regression model. RESULTS The improvement of hearing by method 1 and 2 were 85.71%, 68.00% (P=0.0296). The recovery rate of drying ear were 92.86%, 88.00% (P=0.3931). The proportion of continued tinnitus were 10.71%, 18.00% (P=2827). There were 85.71% and 36.00% samples with numeric pain score from 1 to 3 (P<0.0001). There were 89.29%, 24.00% samples with operation hour <2.0 hour (P<0.0001). For those patients with normal function of stapes, Eustachian and tendon of tensor tympani, the OR of method 1 were 2.91, 3.08 and 3.33 For those patients with abnormal function, the OR was 3.27, 2.89 and 1.33. CONCLUSION Ossicular chain reconstruction without incision of mastoid is a suitable surgical treatment for chronic chronic otitis media,it could improve hearing more effectively with entire debridement of the focus and shorter operation time.