OBJECTIVE: To investigate the changes and determine the difference of electrode impedance and neural response telemetry ( NRT) value with cochlear implants in children with malformed inner ear and normal inner ear. METHOD: Eighty-eight children with multi-channel cochlear implants participated in this study. Children were divided into malformed inner ear group and normal inner ear group. To test the electrode impedance values and NRT value. RESULT: The changes of electrode impedance showed the similar changing pattern in two groups. There was not different in electrode impedance values between the two groups (P > 0.05). The changes of electrode neural response telemetry values showed the similar changing pattern in two groups. There was significantly different in electrode impedance values between the two groups (P < 0.05). The NRT were going up higher from electrode 22 to electrode 1. CONCLUSION The values vary are different programming sessions and electrodes during the first 3 months of cochlear implant use. To acquire better hearing frequent programming sessions are necessary.
Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Ear, Inner ; abnormalities ; physiopathology ; surgery ; Electric Impedance ; Electrodes ; Female ; Humans ; Infant ; Male

Objective To study the distribution of allogenic bone marrow-derived mesenchymal stem cells (BM-MSCs) on joints of collagen-induced arthritis (CIA) rats and to investigate their repair effects on joint damages. Methods Five Wistar rats were used for extraction of mesenchymal stem cells and 30 adult female Wistar rats were divided into 3 groups: the CIA rats group A (n=10), CIA rats group B (n=10) and normal rats control group C (n=10). BM-MSCs of Wistar rats were isolated, cultured in vitro routinely and the fourth passages was taken for identification of specific surface antigens by flow cytometry, then the cells were labeled with 5-bromodeoxyuridine (5-BrdU) in vitro. The models of CIA rats were established. 5-BrdU labeled BM-MSCs (1.0×107 cells/kg) were imfused from through tail vein to CIA rats group A and control group C. During the first 4 weeks after BM-MSCs transplantation, changes of general condition and left hind paw swelling were examined. At the fourth week, immunohistochemical examination of 5 -BrdU and osteoprotegerin (OPG) were performed to investigate BM-MSCs aggregation around the knee joints. The contribution of BM -MSCs to repairing of joint damages was identified. Comparisons between groups were performed by t-test. Results After BM-MSCs transplantation, left hindpaw swelling of group A were relieved compared with group B (P＜0.05) and the mobility of the joints was significantly improved. At the fourth week, much more implanted cells (5-BrdU positive cells.) were detected in the damaged knee joints than those in normal knee joints. The average grey scale values on synovium of knee joints in the CIA group A (85±9) was significantly lower than that of the normal group C (110±6, P＜0.05). At the same time, OPG expression was increased in damaged knee joints. The average grey scale values on synovium of knee joints in CIA group A (54±4) was significantly lower than that of the CIA group B (77±6, P＜0.05). Conclusion The transplanted allogeneic bone marrow mesenchy-mal stem cells can migrate to sites of damaged tissue in arthritis. They can prevent tissue damage and repair the damaged joints tissue by increasing OPG expression. This study has provided some evidence for developing effective therapy for rheumatoid arthritis.

Objective To study the effect of allo-human bone marrow mesenchymal stem cells (BMSCs) on T and B cells from patients with Rheumatoid arthritis (RA) in vitro. Methods BMSCs were isolated from bone marrow samples of healthy volunteers and purified by density gradient centrifugation and cultured in vitro. Peripheral lymphocytes were isolated from patients with RA.Then, BMSCs and lymphpcutes were co-cultured. The modulatory effect of BMSCs on proliferation, activation and maturation of T and B lymphocytes of RA patients stimulated by PHA and SAC respectively was observed. The cell generation cycle and the degree of apoptosis were assessed by flow cytometry with PI/ Annexin V. After co-cultured with or without BMSCs for 72 hours, T cells were harvested, then they were labeled with anti-CD3, anti-CD4, anti-CD8, anti-CD25 antibodies and analyzed by flow cytometry. The density of IgG in the co-culture system was detected by ELISA. Results T and B cells proliferation was significantly suppressed when co-cuhured with bMSCs but did not induce T cell apoptosis. There was a significant decrease in the ratio of CD4+ CD3+ T cells in the co-cuhure group (34±6), as compared with the control group (44±7) (P<0.05). There was a decrease in CD25+ T cells and increase of CD4+ CD25+ cells in BMSCs co-cultured group (P<0.05). IgG was in creased in the cocuhure system. Conclusion Human BMSCs inhibit T and B cell activation and proliferation in patients with RA in vitro. And these immunomodulatory effects are not MHC restricted. The results of this study have provided evidence for the fact that BMSCs has the potential to be an effective treatment for RA.

Objective To isolate and culture bone marrow mesenchymal stem cells (BMSCs) from patients with rheumatoid arthritis (RA) and examine their biological characteristics. Methods MSCs were isolated from bone marrow of RA patients and purified by density gradient centrifugation and cultured in vitro. The morphology, immunophenotype, and proliferative; property of BMSC and colony forming unit-fibroblast (CFU-F) were measured and analyzed. Results The culture expanded cells from RA patients presented a typical fibroblast-like morphology. Ceils were positive for SH2 (CD105), CD71, and CD44, but negative for CD45. Their proliferative capacity and CFU-F number were similar to those of BMSCs from healthy donors. Conclusion In respect to morphology, immuno-phenotype, proliferative property and colony forming unit-fibroblast (CFU-F), MSCs from bone marrow of RA patients are not different from those of MSCs isolated from bone marrow of normal donors. MSCs from the bone marrow of RA patients have the potential for clinical application.

Objective:To examinethe absolute numbers of cluster of differentiation (CD4) + T cell subsets in peripheral blood of patients with rheumatism and further to develop a new immunomodulatory therapies which aimed to restore their imbalanced CD4 + T lymphocyte subpopulation. Methods:A total of 6 395 rheumatic patients [4 430 females, 1 965 males, mean age (49±15) years] and 206 healthy controls (HCs) were enrolled in this retrospective cross-sectional study, which included rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), Psoriatic arthritis (PsA), systemic sclerosis (SSc), primary Sj?gren′s syndrome (pSS), Be?het's disease (BD), dermatomyositis/polymyositis (DM/PM), gout and vasculitis. Some patients received treatment combined with immunoregulatory drugs (IMiDs) such as low-dose interleukin (IL)-2, rapamycin, metformin, retinoic acid and coenzyme Q10. The absolute numbers of T helper cell (Th)1, Th2, Th17 and regulatory T cell (Treg) in peripheral blood (PB) of these individuals were measured by Flow Cytometery (FCM). Independent sample t test and paired sample t test were used to compare the levels of CD4 + T cell subsets in PB of patients and HCs, before and after treatment respectively, and P<0.05 was considered statistically significant. Results:Compared with HCs, the mean absolute number of Treg was significantly decreased [(31±15) cell/μl vs (27±17) cell/μl, t=3.407, P<0.01] and the ratio of Th17/Treg was increased in all patients [(0.3±0.2) vs ( 0.4±0.7), t=-9.508, P<0.01]. There was a significant increase in the number of Th17 in patients with AS [(10±8) cell/μl, t=-5.403, P<0.01], PsA[ (11±11) cell/μl, t=-3.829, P<0.01], SSc [(7±6) cell/μl, t=3.114, P<0.01], BD [(11±9) cell/μl), t=-4.774, P<0.01] and gout [(11±9) cell/μl, t= -4.604, P<0.01) , and we observed lower level of Treg in patients with RA[(28±15) cell/μl, t=3.032, P<0.01], SLE [(21±21) cell/μl, t=6.836, P<0.01], AS [(28±15) cell/μl, t=2.216, P<0.05], SSc [(27±16) cell/μl, t=3.698, P<0.05], BD [(27±17) cell/μl, t=2.502, P<0.05], DM/PM [(27±22) cell/μl, t=2.974, P<0.01) and gout [(28±15) cell/μl, t=2.079, P<0.05). After IMiDs combination treatment, the levels of CD4 + T subsets were increased. Interestingly, the expansion of Treg was much more dramatical than those of other effector T cells, resulting in a decrease in ratios of Th17/Treg, especially in SLE [(0.6±1.0) vs (0.5±0.4), t=3.157 , P<0.01]. Conclusion:Impaired balance of pro- and anti-inflammatory immune cells, especially insufficiency of Treg, might be a cornerstone of the pathogenesis of rheumatism. The new immunomodulatory therapies could relatively specifically promote Treg proliferation and restored patients' autoimmune tolerance, which isexpected to provide a new strategy for the treatment of rheumatism.

Objective To evaluate the clinical value of narrow band imaging(NBI)for diagnosis of malignant and premalignant gastric lesions.Methods The gastric lesions,pits and microvascularity were observed using conventional endoscopy followed by narrow band imaging(NBI)and chromoendoscopy(0.2%indigo carmine)as well as magnifying endoscopy(×80)in 217 patients.The quality of images obtained by different endoscopies was evaluated and compared to pathologic interpretations. Results Of 217 patients,non-atrophic gastritis was found in 85 cases,chronic atrophic gastritis in 38 cases,mild dysplasia in 19 cases,moderate dysplasia in 9 cases,severe dysplasia in 4 cases,early gastric cancer in 5 cases,advanced gastric cancer in 20 cases and intestinal metaplasia in 91 cases.The NBI endoscopy was superior to conventional endoscopy and chromoendoscopy in finding gastric lesions(P=0.000).The gastric microvascularity was more clearly seen on images obtained by NBI combined with magnifying endoscopy in comparison with conventional endoscopy and chromoendoscopy(P=0.000).There were six patterns in description of gastric pits with NBI endoscopy.Type Ⅲ,Ⅳ or Ⅴ1 was usually found in chronic atrophic gastritis,type Ⅲ,Ⅳ,Ⅴ1 or Ⅴ2 in intestinal metaplasia,type V1 or Ⅳ in dysplasia and type Ⅵ in suspected malignant lesion.Conclusions NBl with magnifying endoscopy is helpful in improving the biopsy accuracy of malignant and dysplastic lesions and in detecting early gastric cancer.

Objective To explore the methods for endoscopy nasal microsurgery and multiple techniques in treatment of nasopharyngeal angiofibromas. Methods CT, MRI and digial substraction angiography (DSA) and endoscopic examination had been used. ALL 12 patients accepted preoperative feeding artery embolum, hypotention anesthesia and injected adrenaline-lidocaine. Microelectrotomy-electrocoagulation had been used to remove tumor. Results All patients were treated by endoscopic nasal surgery. No complications had occurred. No recurrence were found in follow-up period. Conclusion The important factors to reduce amount of introperative bleeding are to select proper operative patients and use multiple techniques. Endoscopy nasal surgery has dominance in reducing complications, wound, tumor recurrence, operative time and nasal function.

PurposeVon Hippel-Lindau (VHL) syndrome is a rare autosomal dominant diseases involved multiple organs. This paper aims to explore the clinical and imaging features of VHL syndrome for the improvement of early diagnosis and treatment of this disease.Materials and Methods The clinical and imaging data, as well as their history of 5 patients with VHL syndrome were retrospectively studied. Follow-up was performed and the related literature was also reviewed.Results Among the 5 patients, 4 were found with angioreticulomas. One out of four patients simultaneously suffered from multiple angioreticulomas in brainstem, and another one had multiple cervical cord angioreticulomas. The typical MRI showed multiple cystic and solid mass with mixed intense signals, and the enhanced MRI displayed obvious enhancement in the solid part of the mass. Three patients were diagnosed with renal clear cell carcinomas. The typical CT scan showed equidensity or slightly low density signals, and the enhanced CT scan noted heterogeneous enhancement. Besides, bilateral epididymis cystadenoma occurred in one case. The ultrasonography presented heterogeneous echo and rich blood vessels. The follow-ups had been conducted till January 2015. According to the Glasgow outcome scale, three patients were in good conditions, while the other two died from renal clear cell carcinomas.Conclusion Patients with VHL syndrome usually have an unsatisfactory prognosis and most may die from renal carcinoma. Genetic test and investigation of family history should be performed as early as possible on patients with highly suspected or confirmed VHL Early treatment, life-long follow-up and periodic imaging examinations may be helpful in the prognosis.

Objective To investigate the value of narrow band imaging(NBI) in diagnosis of early gastric cancer(EGC) and dysplasia. Methods 217 patients were enrolled. Routine endoscopy followed by narrow band imaging (NBI), then chromoendoscopy (indigo carmine) combined magnifying endoscopy was sequentially used. The gastric pits and microvasculuture were carefully observed. According to the NBI ima-ges, the biopsy samples were taken in suspicious area to identify malignant and premalignant gastric lesions. The patients with gastric cancer or severe dysplasia required endoscopic uhrasonography(EUS), then EGC or severe dysplasia ones needed endoscopic therapy or surgery. Results In silhouette of gastric lesion, NBI is the clearest in the above three endoscopic methods. Both mucosal pit and epithelium capiUary were shown much clearer by NBI than by routine endoscopy. Of 217 patients, 19 cases of mild dysplasia, 9 cases of moderate dysplasia, 4 cases of severe dysplasia and 5 cases of EGC were finded according to histopathological diagnosis. Six patterns of gastric pits were summarized by NBI. Dysplasia usually behaviored as V1 or Ⅳ gastric pits,and Ⅵ mucosal pit were suspected malignant lesion. Tumorous vessels can be seen in 3 cases of EGC. Conclusion By narrow band imaging system with magnifying endoscopy, the micro gastric mucosal structure can be shown much clear. That is helpful for improving the accuracy of malignant lesion on endo-scopic target biopsies and finding early gastric cancer.

Objective To investigate the diagnostic values of imaging techniques and endoscopy in detection the causes of post-hepatic obstructive jaundice.Methods The clinical data of 57 patients with post-hepatic obstructive jaundice were retrospectively studied.The causes of the obstruction and the findings of uhrasonography(US),computerized tomography(CT),magnetic resonance imaging(MRI)or MRIcholangiopancreatography(MRCP),endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasonography(EUS)were compared.Results The causes of 57 patients with post-hepatic obstruetive jaundice were benign obstruction in 42(including stones in common bile duct in 38,ascariasis of CBD in 1,postoperative stricture in 2 and chronic pancreatitis in 1),and malignant lesions in 15(including pancreatic head carcinoma in 11 and ampullary carcinoma in 4).The diagnostic accuracy in terms of lesion location of US,CT,MRI+MRCP,ERCP and EUS were 71.93%(41/57),88.00%(22/25),94.59% (35/37),100.00%(47/47)and 96.77%(30/31),respectively;the diagnostic accuracy of cause of obstruction were 63.16%(36/57),80.00%(20/25),83.78%(31/37),100%(47/47)and 96.77% (30/31),respectively.Conclusion Benign diseases are the main causes of post-hepatic obstructive jaundice,but malignant ones are not rare.It is important to combine miscellaneous imaging techniques and endoscopy in diagnosis.