To determine the treatment result of Adhesive otitis media, 105 cases(129 cars) were analysed retrospectively. Of them, 70 ears( 54 %) had a small air - room at the tympanic opening of eustachian tube, 12 ears had obstructed eustachian tube. The classification of adhesive otitis media and selection of proper measures were discussed. Further improvement of hearing was still a puzzled problem.

Objective To observe the effects of functional electrical stimulation (FES) based on a normal walking pattern on the lower extremity function of subjects early after cerebral infarction.Methods Twenty patients with cerebral infarction aged (59.7 ± 10.1) years (range 45-80) who were hospitalized and within 3 months (31.1 ± 19.3 days) after the onset were randomly assigned to an FES group (n =11) or a placebo stimulation group (n =9).All subjects in both groups received standard medical and rehabilitation treatment.In addition,the FES group received FES and the placebo group received sham-FES without current output.The daily stimulation and shamstimulation sessions lasted for 30 min,5 d/week for 3 weeks.All of the subjects in the two groups were assessed using the Fugl-Meyer assessment (FMA),postural assessment for stroke patients (PASS),the Berg balance scale (BBS),functional ambulation categories (FACs) and the modified Barthel index (MBI).Results After 3 weeks of treatment,FMA,PASS,BBS and MBI scores had all improved significantly compared with before treatment in both groups,but the FES group showed significantly better improvement.After treatment the average FAC results of both groups had improved,and there was no significant difference between the two groups.At the same time,the research revealed the expected significant correlations among the FMA,PASS,BBS and MBI results.Conclusion FES based on a normal walking pattern can improve lower extremity motor function early after cerebral infarction,improve balance,and improve ability in the activities of daily living.

The occurrence of malignant tunors is increasing annually around the world.In every year,8.2 million patients died of malignant tumors in which about 90％ patients died of malignant tumors associated multiple organs metastases.Inhibiting tumor metastasis is the key event to prolong the survival time of patients.With the further research,tumor-vessel associated extravascular tumor metastasis is playing an increasingly important role in the clinical application.This paper summarizes the new developments of tumor-vessel associated extravascular tumor metastasis to provide possible ideas for the therapy of malignant tumors.

Objective To investigate the character and location of a novel gene R049 and its expressed protein in uropathogenic Escherichia coli(UPEC) strain 132 isolated in China. MethodsThe chromosome library of UPEC132 was constructed by a shotgun strategy and the sequence analysis was carried out by a high-throughput pyrophosphate sequencing. Sequence reads were assembled with the Newbler program.The characters of R049-associated specific fragment were analyzed using the bioinformatics methods. Outer and inner membrane proteins of UPEC132 were extracted and then detected by SDS-PAGE and Western blot analysis together with the whole-cell lysates. ResultsThe 169 022 bp contig containing gene R049 was obtained and its sequence was very similar to the chromosome associated sequence of UPEC strain 536. It showed that a 20 773 bp fragment including R049 replaced the pathogenicity island PAI Ⅲ536 of UPEC536 in above 169 022 bp contig. The fragment had a lower GC content (46.97％) and 16 bp direct repeats in two ends. Significantly it also was adjacented to thrW tRNA, insertion element and genes coding integrase. Thus the 20 773 bp fragment was named R049 genome island(R049-GI). There were 25 ORFs in R049-GI, and gene R049 was located in the thirteenth ORF. The results of SDS-PAGE and Western blot revealed gene R049 encoded an outer membrane protein in the size of 47.0× 103. ConclusionGene R049, encoding an outer membrane protein, was a component part of the genome island in UPEC 132 chromosome acquired by horizontal gene transfer.

Objective To investigate the effects of electroacupuncture (EA) on spatial learning and memory ability, long-term potentiation (LTP) and synaptophysin (Syp) levels in the dentate gyrus of the hippocampus.Methods Forty Sprague-Dawley rats were randomly divided into a sham-operated control group, a model group, an EA group and a medication group. A rat model of vascular dementia (VD) was established by repeated ischemia and reperfusion after pretreatment with sodium nitroprusside. EA was applied to the rat homologues of the human "Baihui" (GV20) and "Dazhui" (DU14) acupoints of the rats in the EA group for 20 min, once daily for 10 d.Morris water maze tests were conducted for evaluating the rats,learning and memory ability. LTP in the hippocampal dentate gyrus was recorded as an electrophysiological index for evaluating learning and memory. Antigenic Syp produced in hippocampal tissue was examined with immunohistochemical assays. Results In comparison the with model group, escape latency (EL) shortened and target-platform crossing times increased significantly in the EA and medication groups. After high frequency stimulation the population spike (PS) latency shortened in the EA group compared with the model group, and the excitatory postsynaptic potential (EPSP) slope and PS amplitude increased.All of these differences were statistically significant. Syp positive cells also increased significantly in the EA-treated rats. Conclusions EA can increase Syp expression and improve the learning and memory ability of rats with this model of VD. EA could facilitate the induction and maintenance of LTP in the dentate gyrus of the hippocampus through influencing synaptic transmission.

Objective To explore the incidence and risk factors of anti-tuberculosis (TB) drugs induced liver injury (ATDILI) and to discuss its impact on the treatment outcome of patients treated with first line anti-TB drugs.Methods Among the patients who received anti-TB treatment with directly-observed treatment strategy (DOTS),121 patients with ATDILI and 817 patients without ATDILI were included in this retrospective cohort study.Binary Logistic regression model was used to analyze the risk factors of ATDILI in univariate and multivariate analysis.The x2 test was used to compare the treatment success rates and drug resistant rates.Kaplan-Meier analysis and Log-rank test were used to compare the sputum smear/culture conversion rates and cavity closure rates.Results The incidence of ATDILI was 12.9％ (121/938) in this cohort.Multivariate Logistic regression showed that hepatitis B virus carrier with both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) positive (OR=4.29,95％CI:2.15-8.58,P＜0.01),complicated with systemic lupus erythematosus (OR=3.34,95％CI:1.46-7.63,P=0.004),serum albumin ≤25 g/L (OR=3.14,95％CI:1.50-6.58,P=0.002) and alcoholism (OR=1.79,95％CI:1.14-2.82,P=0.012) were independent risk factors of ATDILI.The treatment failure rate in patients with ATDILI was significantly higher than that in patients without ATDILI (19.1％[24/121] vs8.0％[65/817],OR=2.86,95％CI:1.71-4.78,P＜0.01).The drug resistant rates of two groups were not significant different (4.1％[5/121] vs 1.7％[14/817],P＞0.05).The sputum smear/culture conversion rate (85.4％[41/48] vs 94.0％ [298/317],x2 =38.912,P＜0.01) and cavity closure rate (84.6％[22/26] vs 93.0％[198/213],x2 =20.709,P＜0.01) in patients with ATDILI were both significantly lower than those in patients without ATDILI.Conclusions The incidence of ATDILI is relatively high in hospitalized patients treated with first line anti-TB drugs.ATDILI has negative effects on treatment outcome of TB patient.Hepatitis B carrier with positive HBsAg and HBeAg,systemic lupus erythematosus,albumin ≤25 g/L and alcoholism may increase the risk of developing ATDILI.

Objective To evaluate the effect of controlling cost by introducing hand hygiene products with lower price on promoting hand hygiene compliance.Methods The application status and cost of hand hygiene products in 2012 was as pre-intervention group,2013 was as post-intervention group.Effective and lower price hand hygiene products were introduced in 2013,consumption and cost of hand hygiene products before and after the intervention was compared.Results Consumption of hand hygiene products per patient-day before and after the intervention was significantly different ([10.56±16.46]mL vs [13.79 ± 16.93 ]mL,Z=4.14,P <0.01 );cost of hand hygiene products per patient-day before and after the intervention was not significantly different ([1 .23 ±2.07]yuan vs [0.92±0.59]yuan,P >0.05).Conclusion Introduction of hand hygiene products with lower price in this hospital can improve hand hygiene compliance to certain degree without increasing the cost of hand hygiene.

Objective To evaluate the changes in the activity of extracellular signal-regulated protein kinase 5 (ERK5) in the spinal cord in a rat model of bone cancer pain (BCP).Methods One hundred and eight female Sprague-Dawley rats,weighing 160-180 g,were randomly divided into 3 groups (n =36 each):control group (group C):sham operation (group S) and group BCP.In group BCP Walker 256 mammary gland cancer cell suspension (1 × 105 cells/ml) 5 μl was injected into the left tibia,while in group S normal saline 5μl was injected into the left tibia instead of cancer cell suspension.Group C underwent no treatment.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 day before inoculation and 3,5,7,14 and 21 days after inoculation.Six rats were sacrificed after the last measurement of MWT in groups C and S or after measurement of MWT at 3,5,7,14 and 21 days after inoculation in group BCP and the spinal cord was removed for determination of the expression of phosphorylated ERK5 (p-ERK5),ERK5 and Fos protein in the spinal dorsal horn by Western blot analysis.Results There was no significant difference in the MWT and expression of p-ERK5,ERK5 and Fos protein at each time point between groups C and S (P ＞ 0.05).Compared with groups C and S,MWT was significantly decreased at 7-21 days after inoculation,the expression of p-ERK5 and Fos protein was significantly up-regulated at 5-21 days after inoculation (P ＜ 0.05),and no significant change was found in the expression of ERK5 in group BCP (P ＞ 0.05).Conclusion Intra-tibial inoculation of Walker-256 breast cancer cells can increase the activity of ERK5 in the spinal cord in rats,leading to the increased release of Fos protein,thus inducing BCP.

Objective To evaluate the image quality of hand tendons by using spectral CT,compared with conventional CT ima-ges.Methods Forty patients scanned with spectral CT were enrolled.The 65keV of optimal contrast-to-noise ratio (Optimal CNR) for viewing hand tendons was selected.The image quality of monochromatic GSI images (65 keV)and conventional CT images were compared with two different methods including subjective method and objective method by two radiologists respectively.Results In subjective method,the image quality in GSI images was superior to conventional CT images (P <0.05).And in objective method, the beam-hardening artifacts in the phalanges of fingers space were reduced markedly with hand tendons displaying more clearly in GSI images (P <0.05 ).There was no significant difference between the two radiologists in both methods with good correlation (Kappa=0.75,Kappa=0.85).Conclusion Spectral CT with the optimal 65keV monochromatic images could reduce the artifacts and increase image quality significantly in hand tendons imaging.It might be a very useful supplementary imaging method in detec-ting tendon diseases in routine work.

Objective To provide immunological evidence for clinical transfer of chemical extracted acellular nerve allografL Methods One hundred and twenty-eight BALB/C mice were randomly divided into 4 groups of equal size according to their different treatments:negative contrast group(NC),fresh autograft group(AG),fresh allogeneic nerve group(FN)and chemical extracted aceflular allogeneic nerve group(CEN).Then we implanted various kinds of nerve grafts into the thigh muscle of BALB/C mice in corresponding groups.At 3,7,14,28 days postoperatively,8 mice from each group were killed each time to harvest their spleens,from which T lymphocytes were collected.Theu monoclonal antibodies(CD3,CD4 CD8 CD25,IL-2,IFN-γ, TNF-α)were added into the suspension.Then fluorescence.activated cell sorting(FACS)was used to determine the positive rates of cells combined with the above monoclonal antibodies. Results There were no statistically significant differences between CEN group,NC group,and AG group,but indexes of FN group were significantly higher than those of the other 3 groups at corresponding time points. Conclusion There is no obvious immune reiection of chemical extracted acellular nerve allograft when compared with fresh nerve autograft.