OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

Objective To isolate enterovirus 71 from a death children,and analyze whether the neurovirulence was related to the variation of nucleotide and amino acid. Methods Enterovirus 71 was isolated from throat swabs which were colleted from Shandong Linyi People's Hospital. The full length genome was sequenced by amplification with RT-PCR and sequencing of 9 overlapped gene fragments covering full length of the genomes. The nucleotide and amino acid sequenced was aligned by BLAST, Bioedit and MEGA 4. Results A strain of enterovirus 71 was isolated and named as SDLY107. The full length was 7405 bp. The results of homology analysis of overall nucleotide sequence showed that strain Fuyang. Anhui. P. R. C/17.08/2 had highest homology (98.6%)with strain SDLY107, and the homology was 80.0% between strain SDLY107 with prototype strain BrCr/70,and 86. 5% between strain SDLY107 with nerve strain MS/87. Phylogenetic analysis showed that the phylogeny was close between SDLY107 with some isolated strains from Chinese Mainland, such as Beijing, Henan, Guangxi, Sbenzhen, Lanzhou, Fuyang, Chongqing and Zhejiang strains, which was clustered for C4 subtype. The results of amino acid sequence analysis showed that there were 2 mutations, E947D and K1873R, for strain SDLY107. Conclusion SDLY107 belonged to C4 subtype, amino acid mutations E947D and K1873R of which may be relevant to the pathogenicity of EV71.

Objective To evaluate the left ventricular segmental and global systolic myocardial function of the hypertrophic obstructive cardiomyopathy (HOCM) before and after transcoronary ablation of septal hypertrophy (TASH).Methods Twenty-six consecutive patients with HOCM were analysed by two-dimensional speckle tracking imaging (STI) before and after TASH.The left ventricular global and segmental systolic longitudinal strains and circumferential strain were measured.Results In the HOCM patients,the global and segmental longitudinal strains were lower than the healthy population before TASH.One week after TASH,a significant reduction of left ventricular outflow tract (LVOT) gradients occurred (P ＜ 0.001).The global and the alcohol-treated septal segmental longitudinal strains also decreased significantly[(-12.5±1.7)％ vs (-13.6± 1.6)％,P＜0.01;(-11.2±2.8)％ vs (-12.6±3.1)％,P ＜ 0.001].During 1 year follow-up after TASH,the mean NYHA function class improved after TASH (P ＜ 0.001) and the left ventricular outflow tract (LVOT) gradients and septal thickness decreased (P ＜0.001).The left ventricular global longitudinal systolic strain was increased [(-14.7 ± 2.0) ％ vs (-13.6 ±1.6) ％,P ＜0.01],and this was correlated with the decrease of the LVOT gradients (r =0.579,P ＜0.01).The alcohol-treated septal segments showed unchanged average longitudinal strain over time,while in the anterolateral and the anterior segments,the average longitudinal systolic strain increased (P ＜0.05).The basal and medial segments also showed increased average longitudinal systolic stain.However,the left ventricular circumferential strain had no changes after TASH.Conclusions TASH can significantly decrease the LVOT gradients and improve NYHA functional class with the increase of the left ventricular global and segmental longitudinal systolic function.

Objective To study reaction principle of bilirubin vanadate oxidation method and bilirubin oxidase method through comparison of the determination results,and discuss similarities and difference between the two methods .Methods 310 ca-ses were measured and analyzed with each method.Abnormal samples were further investigated.Results Fortotal bilirubin, the regression equation obtained wasY=1.065 1X+1.197 2,the correlation coefficientr=0.997 0.For direct bilirubin of a-dults and children greater than 30 days,the regression equation wasY=0.945 9X+0.599 5 and the correlation coefficient r=0.994 4.For neonatal direct bilirubin,the regression equation wasY=0.410 4X+2.756 3 and the correlation coefficient r=0.883 5.The results from vanadate oxidation method were unacceptable for abnormal neonatal serum measurement after serial dilution.Conclusion The overall conclusions were that for the measurement of total bilirubin,and direct bilirubin for adults and children older than 30 days.The correlation between these two methods is in an acceptable range,for measure-ment of neonatal direct bilirubin,the correlation between thesetwo methods was not acceptable.It is not recommended to measure neonatal direct bilirubin by vanadate oxidation method.

Objective To explore the status,developing demands and directions of the education and training of military medical equipment.Methods The main problems of the PLA's medical equipment education and training were analyzed via being compared with those of foreign armies.According to the requirements on the campaign mode changing in the future war,the innovating mode under information-based military training,and the research and exploration of novel equipment and new technology,the developing directions in the future were ascertained.Results The interface was enhanced between new medical equipment development and educational training,and specifications were prepared for medical equipment application and maintenance.Conclutsion Exploring the pivot choke points and the developing directions will provide strategy guidance on the rapid and highly efficient elevation of military medical equipment supporting capacity.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.

Objective To compare the degree of cell injury induced by 3D protein (SDLY11 and SDLY107) of enterovirus 71 (EV71) strains.Methods EV71 strains SDLY11 and SDLY107 were respectively isolated from children with mild and severe hand foot mouth disease.The target genes 11-3D-Flag and 107-3D-Flag were amplified by reverse transcription-polymerase chain reation (RT-PCR) and inserted into the eukaryotic expression vector pcDNA3.1.The recombinant plasmids 11-3D-Flag-pcDNA3.1 and 107-3D-Flag-pcDNA3.1 were transformed into Escherichia.coli DH5α, respectively, and were identified by enzyme digestion and sequencing.The recombinant plasmids were transfected into rhabdomyosarcoma (RD) cells, respectively.Expression of 3D protein was detected by indirect immunofluorescence assay and western blot.Cell injury induced by 3D protein was detected with lactate dehydrogenase (LDH) test, cell proliferation was detected by 3-(4,5-dimethylthiazolyl-2)-2,5-diphenylthiazolium bromide (MTT) test, and cell apoptosis was detected with Annexin-V and PI.Multiple comparisons among groups were analyzed using LSD-t test if multiple sets of variables were consistent with homogeneity of variance.If not, Dunnett T3 test was used.Results The 1 400 bp fragments were amplified by reverse tramscription (RT)-polymerase chain reaction (PCR), and the recombinant plasmids were digested by enzyme and the 1 400 bp and 5 400 bp fragments were obtained and identified.Gene sequencing showed that the sequences were consistent with the target genes.The specific fluorescence was observed by indirect immunofluorescence assay, and the western blot showed that the molecular weight of the target protein was 55×103.The LDH test showed that the A490 of SDLY11 3D protein transfection group (0.790±0.048) was higher than that of SDLY107 3D protein transfection group (0.641±0.018).The difference was statistically significant (t=5.14, P<0.05).The cell membrane damage caused by SDLY11 3D protein was more severe than SDLY107 3D protein.The MTT test showed that the A570 of SDLY11 3D protein transfection group (1.028±0.020) was lower than that of SDLY107 3D protein transfection group (1.081±0.002), and the difference was statistically significant (t=3.31, P<0.05).The effect on cell proliferation activity of SDLY11 3D protein was greater than SDLY107 3D protein.The results of Annexin-V/PI showed that the percentage of apoptotic cells of SDLY11 3D protein transfection group and SDLY107 3D protein transfection group were (1.471±0.246)% and (1.465±0.237)%, respectively, and the difference was not statistically significant (t=0.04, P=0.973).Conclusions Compared with the SDLY11 3D protein, SDLY107 3D protein induces slighter cell injury, has weaker effect on cell proliferation activity, and is more favorable for virus replication in cells.

Objective To analyze the value of ovary ultrasonic features and endocrine indicators in patients with polycystic ovary syndrome.Methods A total of 218 polycystic ovary syndrome between February 2013 and March 2015 were selected as research objects.And they were divided into HOMA-IR insulin resistance group (n =115) with HOMA-IR more than 2.69,and non insulin resistance group (n =103 cases) with HOMA-IR less than 2.69.And another 69 healthy people were selected in the same period as control group.The ovary ultrasonic features such as ovarian capsule thickness,ovary diameter,maximum diameter of follicle,OV,follicular volume,follicle count,flow indicators were checked.And the endocrine indicators such as FSH,LH,LH/FSH,E2,T,PRL,FINs,FPG,SHBG were determined.Results The ovarian capsule thickness,OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group and non insulin resistance group were more than control group (P ＜ 0.05).The OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group were more than non insulin resistance group,maximum diameter of follicle was less than non insulin resistance group (P ＜ 0.05).The LH,LH/FSH,FSH,FINs and T of insulin resistance group and non insulin resistance group were more than that of controlgrouD (P ＜ 0.0 5).SHBG and E2 were less than control group (P ＜ 0.0 5).FPG of insulin resistance group was more than control group (P ＜ 0.0 5).The T and FINs of insulin resistance group were more than non insulin resistance group (P ＜ 0.05).The SHBG of insulin resistance group was less than non insulin resistance group (P ＜ 0.05).Single factor correlation analysis showed that OV was positively correlated with LH/FSH,T,BMI and HOMA-IR(r =0.255,0.267,0.534,0.427,P ＜0.05),maximum diameter of follicle was negatively correlated with T,HOMAIR,BMI (r =-0.426,-0.433,-0.317,P ＜ 0.05).FSH was positively correlated with follicle count (r =O.817,P ＜ 0.05).Conclusion The maximum diameter of follicle is decreased,and OV is magnified of insulin resistance type of polycystic ovary syndrome.OV is positively correlated with LH/FSH,T,BMI and HOMA-IR.Maximum diameter of follicle is negatively correlated with T,HOMA-IR,and BMI.FSH was positively correlated with follicle count.

Objective To analyze the value of ovary ultrasonic features and endocrine indicators in patients with polycystic ovary syndrome.Methods A total of 218 polycystic ovary syndrome between February 2013 and March 2015 were selected as research objects.And they were divided into HOMA-IR insulin resistance group (n =115) with HOMA-IR more than 2.69,and non insulin resistance group (n =103 cases) with HOMA-IR less than 2.69.And another 69 healthy people were selected in the same period as control group.The ovary ultrasonic features such as ovarian capsule thickness,ovary diameter,maximum diameter of follicle,OV,follicular volume,follicle count,flow indicators were checked.And the endocrine indicators such as FSH,LH,LH/FSH,E2,T,PRL,FINs,FPG,SHBG were determined.Results The ovarian capsule thickness,OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group and non insulin resistance group were more than control group (P ＜ 0.05).The OV,ovary diameter,follicular volume,follicle count,flow indicators of insulin resistance group were more than non insulin resistance group,maximum diameter of follicle was less than non insulin resistance group (P ＜ 0.05).The LH,LH/FSH,FSH,FINs and T of insulin resistance group and non insulin resistance group were more than that of controlgrouD (P ＜ 0.0 5).SHBG and E2 were less than control group (P ＜ 0.0 5).FPG of insulin resistance group was more than control group (P ＜ 0.0 5).The T and FINs of insulin resistance group were more than non insulin resistance group (P ＜ 0.05).The SHBG of insulin resistance group was less than non insulin resistance group (P ＜ 0.05).Single factor correlation analysis showed that OV was positively correlated with LH/FSH,T,BMI and HOMA-IR(r =0.255,0.267,0.534,0.427,P ＜0.05),maximum diameter of follicle was negatively correlated with T,HOMAIR,BMI (r =-0.426,-0.433,-0.317,P ＜ 0.05).FSH was positively correlated with follicle count (r =O.817,P ＜ 0.05).Conclusion The maximum diameter of follicle is decreased,and OV is magnified of insulin resistance type of polycystic ovary syndrome.OV is positively correlated with LH/FSH,T,BMI and HOMA-IR.Maximum diameter of follicle is negatively correlated with T,HOMA-IR,and BMI.FSH was positively correlated with follicle count.