This paper makes persuasive demonstrations on some problems about the human ear sound transmission principle in existing physiological textbooks and reference books, and puts forward the authors' view to make up for its literature. Exerting the knowledge of lever in physics and the acoustics theory, we come up with an equivalent simplified model of manubrium mallei which is to meet the requirements as the long arm of the lever. We also set up an equivalent simplified model of ossicular chain--a combination of levers of ossicular chain. We disassemble the model into two simple levers, and make full analysis and demonstration on them. Through the calculation and comparison of displacement amplitudes in both external auditory canal air and internal ear lymph, we may draw a conclusion that the key reason, which the sound displacement amplitude is to be decreased to adapt to the endurance limit of the basement membrane, is that the density and sound speed in lymph is much higher than those in the air.
Acoustics ; Ear Canal ; Ear Ossicles ; physiology ; Ear, Inner ; physiology ; Humans ; Lymph ; Models, Anatomic ; Sound

Objective To investigate the preoperative biliary drainage on the effect of surgical treatment for hilar cholangiocarcinoma patients.Methods A total of 52 hilar cholangiocarcinoma patients who underwent resection operation in Renmin Hospital of Wuhan University from January 2005 to December 2015 were divided into preoperative biliary drainage group (24 cases) and non-preoperative biliary drainage group (28 cases).To compare the operation time,intraoperative blood loss,hospital stay,perioperative changes in liver function,and incidence of postoperative complications,tumor recurrence rate,1-,3-,and 5-year survival rate and some other indicators.The data was analyzed using SPSS 19.0 software.The patients of two groups were followed up by telephone,out-patient review and hospital examination.Patients were followed up for 8-60 monthes.Results The hospital stay for biliary drainage group was longer than that in non-preoperative biliary drainage group and the difference was statistically significant (P ＜ 0.05).The differences of operation time,intraoperative blood loss,postoperative tumor recurrence rate,postoperative complications (including bile leakage,blooding,fever,pleural effusion,abdominal infection,wound infection,pulmonary infection,liver failure and some others) and 1-,3-,and 5-year survival rate were not statistically significant (P ＞ 0.05).Alanine aminotransferase,aspartate aminotransferase,total bilirubin and direct bilirubin in preoperative biliary drainage group before biliary drainage were(98.0 ± 51.7) U/L,(94.2 ± 44.2) U/L,(177.5 ± 64.1) μmol/L and (160.2 ± 61.9) μmol/L,respectively,and after biliary drainage were (71.2 ± 13.8) μmol/L,(60.0 ± 12.1) μmol/L,(93.5 ± 20.7) μmol/L and (76.3 ± 18.1) μmol/L,respectively.The differences of the above parameters before and after biliary drainage were statistically significant (P ＜ 0.05).However,the changes of albumin before and after biliary drainage were not significant (P ＞ 0.05).The follow-up patients of biliary drainage group were 21 cases and the follow-up patients of non-preoperative biliary drainage group were 25 cases.The differences of 1-,3-,and 5-year survival rate between the two groups were not statistically significant (P ＞ 0.05).Conclusions Preoperative biliary drainage for hilar cholangiocarcinoma patients may improve the liver function to a certain extent.However,preoperative biliary drainage cannot improve the prognosis of the hilar cholangiocarcinoma patients.Therefore preoperative biliary drainage is not suggested for patients with good general conditions.

ABSTRACT:Objective To study the effects of arotinolol,propranolol and carvedilol on rat portal hypertension and make a comprehensive evaluation of the three drugs.Methods Portal hypertension was induced with CCl4 in rats.Arotinolol,propranolol,and carvedilol were administered for 2 weeks after the model was stable.Mean arterial pressure (MAP),heart rate (HR)and portal venous pressure (PVP)were measured at intubation;α-SMA expression was measured by immunohistochemistry;Masson staining was used to test collagen fibers area.Results Compared with model group,both arotinolol and carvedilol could significantly reduce PVP level (P <0.001),which was lower than that in propranolol group (P <0.001,P =0.032).Compared with those in model group,both MAP and HR in arotinolol group and carvedilol group were significantly reduced (P <0.05),MAP in carvedilol group was lower than in arotinolol group (P = 0.01 1 ).MAP was obviously decreased in propranolol group compared with model group (P =0.003),but HR had no sighificant difference between the two groups (P =0.143).Only TBIL in arotinolol and propranolol groups reduced significantly compared with model group (P <0.001 ).However,ALT, ALB and TBIL were obviously ameliorated in carvedilol group compared with model group (P <0.001,P <0.001, P =0.045).The expression ofα-SMA and the area of collagen fibers in arotinolol,carvedilol and propranolol groups
significantly declined compared with those in model group (P <0.05 ).Conclusion Arotinolol can significantly reduce cirrhotic rats’ portal pressure,with effects similar to those of carvedilol.The effect of arotinolol in improving liver function is weaker than that of carvedilol,but the side effects on MAP are milder than those of carvedilol.

Objective To explore extracellular signal-regulated kinase ( ERK1/2 ) expression in the role of curcumin inhibited staurosporine (STS)-mediated neurons toxic injury through added PD098059, and to clarify ERK1/2 mediated inhibitory role of curcumin on STS-induced neurons toxic injury.Methods The neurons toxic injury model of primary cultured hippocampal neurons was established by STS.The experiment was divided into six groups:normal control group, STS model group, PD098059 +STS model group, curcumin +STS pretreatment group, curcumin+PD098059+STS treatment group and curcumin treatment group.The cell viability were determined by MTT method, lactate dehydrogenase (LDH) release rate, cell toxicity were detected, nuclear shape were observed by DAPI staining, and ERK1/2 expression were detected by Western blot method.Results The cell viability of curcumin +STS pretreatment group was significantly higher than STS model group ( P <0.001 ); the cell viability had no significant difference between PD098059 +STS model group and curcumin +PD098059 +STS treatment group;compared with curcumin +STS model group , the cell viability of curcumin +PD098059 +STS treatment group was significantly decreased ( P<0.001 ).LDH results showed that the nerve cell toxicity of curcumin +STS pretreatment group was obviously less than STS model group (P<0.001).The cell nuclear shape showed typical apoptosis morphological characteristics in STS model group, and curcumin inhibited the effect of STS mediated-neuronal apoptosis.ERK1/2 protein expression in curcumin +STS pretreatment group significantly increased compared with STS model group ( P <0.001 ) .Conclusion Curcumin inhibited STS-mediated neurons toxicity injury by up-regulating ERK1/2 expression.After PD098059 blocking the nerve cells ERK1/2 synthesis, the inhibitory action of curcumin failed to implemented, which illustrated that ERK1/2 mediated curcumin to inhibit STS-induced neuronal toxic injury.

BACKGROUND:With good biocompatibility, bioactivity, control able biodegradation rate, amorphous calcium phosphate is considered as a natural reservoir of calcium and phosphorus, which has been widely used in the biomedical field. OBJECTIVE:To review the latest progress of amorphous calcium phosphate in biomedicine based on its clinical application and characteristics. METHODS:A computer-based search of CNKI, Wanfang database and PubMed database from January 1980 to June 2014 was performed for articles relevant to amorphous calcium phosphate materials with the key words of“amorphous calcium phosphate, biomaterials”in Chinese and English. RESULTS AND CONCLUSION:Amorphous calcium phosphate has been widely used in orthodontic care, bone substitutes, drug delivery material and stents, but it is stil in the developmental stage for the special low differentiated cells, cytokines, targeted drug delivery materials and new biodegradable coronary stent. Based on amorphous calcium phosphate, there are various possible treatments for human diseases. But we cannot blindly exaggerate its advantages but outweigh its disadvantages. For example, whether it wil increase the formation of dental calculus during prevention of dental caries? Whether it wil promote its adjacent tissue calcification or hardening? And whether there are risks leading to vascular calcification or hardening? The advantages and disadvantages of amorphous calcium phosphate when used in human are stil needed to carry out a large scale and long-time research.

Objective To investigate the role of PET-CT in evaluating the response to the treatment in patients with multiple myeloma.Methods 55 newly diagnosed multiple myeloma patients were collected.Patients were provided with 3 CTD chemotherapy,complete blood examination before and after treatment,parallel PET-CT,and measuring the spine,pelvis,rib SUVmax,each with an average of the SUVmax.The curative effect observated in SUV changes and disease were evaluated.Results In 24 patients after treatment,CR,SUV values were significantly decreased [(3.82±0.83) vs (2.05±0.49),t=9.045,P ＜ 0.001].11 cases of VGPR,SUV values were decreased [(4.77±1.13) vs (3.29±0.49),t =3.998,P =0.001].9 cases of PR,SUV values were slightly decreased [(5.36±0.47) vs (4.97±0.40),t =1.886,P ＞ 0.05],in 8 cases of SD,the SUV values had no obvious change [(6.40±0.96) vs (5.63±0.69),t =1.819,P ＞ 0.05],in 3 cases of disease progression we had higher SUV values from the previous [(6.57±0.72) vs (7.53±4.69),t =-0.353,P ＞ 0.05].CR of 24 cases were followed up for 12 months,SUV values were still high in patients after treatment of the short progression-free survival (PFS) (Some patients only lasted 4 months).Conclusion PET-CT has important value in the evaluation of therapeutic effect of multiple myeloma,it helps to determine the early clinical efficacy,and to plan individualized treatment.

Objective To investigate the prognostic significance of serum cystatin C in multiple myeloma (MM).Methods 160 cases of newly diagnosed MM patients with average age of 61.38 years old.Determine the levels of serum cystatin C,serum creatinine,β 2-microglobulin,lactate dehydrogenase and hemoglobin before the treatment; median follow-up of 38 months,observe the relationship between serum cystatin C with overall survival (OS) and event-free survival (EFS).Results Median serum cystatin C level in 160 MM patients was higher than that in the 80 healthy controls [(0.96 ± 0.32) mg/L vs (0.71 ± 0.16) mg/L,P ＜ 0.000].All the patients in ISS stage were divided into 3 stages.Median serum cystatin C levels significantly increased in higher ISS stages [stage Ⅰ (0.70±0.13) mg/L,stage Ⅱ (0.87±0.16) mg/L,stage Ⅲ(1.23±0.33) mg/L (P ＜ 0.05)],serum cystatin C level was positively correlated with levels of serum creatinine (r =0.669,P ＜ 0.000),β2-microglobulin (r =0.672,P ＜ 0.000).lactate dehydrogenase (r =0.521,P ＜ 0.000),and negatively correlated with hemoglobin levels (r =-0.436,P ＜ 0.000).Using ROC analysis,patients with serum cystatin C levels ＞ 0.95 mg/L had significantly shorter EFS and OS patients with serum cystatin C levels ≤0.95 mg/L (median EFS:30 vs 57 months,P ＜ 0.05; median OS:43 vs 68 months,P ＜ 0.05).Conclusion Serum cystain C is not only a sensitive marker of kidney damage,but also reflects tumor burden and delivers prognostic information in MM.

BACKGROUND:In recent years, pathological calcification such as vascular calcification has been an active deposition of the mineralizer in the abnormal parts, can promote the occurrence and development of many diseases. Moreover, extensive studies believe that micro-inflammatory state is strongly associated with pathological calcification. OBJECTIVE:To further summarize the relationship between micro-inflammatory state and calcification based on the relationship between inflammatory factor and calcification-related factors. METHODS: A computer-based search of CNKI, Wanfang database and PubMed database from January 2000 to January 2015 was performed for articles addressing the relationship between micro-inflammatory state and calcification. The key words were “calcification, micro-inflammatory state, inflammatory factor” in Chinese and English. RESULTS AND CONCLUTION:Micro-inflammatory state is a non-dominant inflammatory state, caused by an infection of non-pathogenic microorganisms, mainly for the elevated inflammatory protein, inflammatory cytokines in the systemic circulation. At present, pro-inflammatory cytokines interleukin-1, interleukin-6, interleukin-8, tumor necrosis factor-alpha and acute phase protein C reactive protein were considered as the objective and sensitive detection index of micro-inflammation state. A large number of studies have found that a slight elevation of interleukin-1, interleukin-6, interleukin-8, tumor necrosis factor-alpha and C reactive protein was positively correlated with calcification promoting factors, which ilustrated that the micro-inflammatory state has the role of promoting the calcification.

Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.

Objective To evaluate the cytogenetic, molecular responses and safety of generic imatinib in newly diagnosed patients with chronic myelogenous leukemia in chronic phase (CML-CP) in 1-year at different stages. Methods From January 2014 to November 2014, 50 CML-CP patients received oral generic imatinib 400 mg/d. The cytogenetic examinations, bcr-abl transcript levels and safety were monitored after 3, 6, 9 and 12 months respectively. Results 46 of 50 patients insisted on oral generic imatinib and followed up 1 year. At 3-month, 52.0 % (26/50) patients reached the complete hematologic responses (CHR) rate, and patients at least achieved minor cytogenetic response (mCyR) and bcr-ablIS≤10 % were 84.0 % (42/50) and 42.0 % (21/50). At 6-month, patients at least achieved part cytogenetic response (PCyR) and bcr-ablIS≤10 %were 73.5 % (36/49) and 59.2 % (29/49). At 12-month, patients achieved complete cytogenetic response (CCyR), bcr-ablIS≤1 % and bcr-ablIS≤0.1 % were 60.9 % (28/46), 63.1 % (29/46) and 45.7 % (21/46). The grade 3 leukopenia, thrombocytopenia and anemia rates were 34 % (17/50), 40 % (20/50) and 30 % (15/50), respectively. No grade 4 hematologic toxicity occurred. The common non-hematologic toxicities included edema [84 % (42/50)], nausea [46 % (40/50)], muscle pain [20 % (10/50)], rash [16 % (8/50)], and impaired liver function [8 % (4/50)]. Conclusion Generic imatinib has a favorable effect in treatment of patients with CML-CP, and without serious adverse reactions.