Objective To observe the clinical curative effect of BudesonideNasal Spray plus Gelomyrtol Forte for acute secretory otitis media.Methods 80 Patients (108ears) and 60 patients (74ears) were treated by BudesonideNasal Spray be bound to Gelomyrtol Forte and Cefaclor Dispersible Tablets res pectively. After 10 days, observe the two groups’s clinical curative effect for acute secretory otitis media.Results The of treatment’s group efficient rate is 99.07, Cefaclor Dispersible Tablets 87.84, and the difference is (?2 =10.68 P0.05), and mild adverse reactions will be disappeared after stoping drugs. Conclusion The of BudesonideNasal Spray puls Gelomyrtol Forte is better than that of Cefaclor Dispersible Tablets for acute secretory otitis media. The mild adverse reaction is the same between the two groups.

Objective:To observe the effects of ultrasound-guided paravertebral nerve block combined with general anesthesia on intraoperative stress response, hemodynamics and postoperative pain of patients undergoing laparoscopic cholecystectomy.Methods:A total of 92 patients undergoing elective laparoscopic cholecystectomy in Wuhan Third Hospital between January 2017 and August 2019 wereselected. They were divided into the control group (63 cases) and the observation group (29 cases) by voluntary. The control group were given simple general intravenous anesthesia, and the observation group were given ultrasound-guided paravertebral nerve block combined with general intravenous anesthesia. Changes in hemodynamic parameters and concentrations of blood angiotensin-Ⅱ (AT-Ⅱ) and cortisol (Cor) in the two groups were observed. The cerebral state indexes (CSI) of both groups were recorded, and pain degree of patients was evaluated with the visual analogue scale (VAS).Results:The mean arterial pressure (MAP) and heart rate (HR) of the observation group were higher than those of the control group at 30 min after anesthesia, 30 min after operation, 3 hours after operation ( P<0.05), the stroke volume variation (SVV) was lower than that of the control group ( P<0.05); the AT-Ⅱ, Cor and CSI in the observation group were lower than those in the control group at each time point ( P<0.05); The dosage of narcotic drugs in the observation group was significantly lower than that in the control group ( P<0.05); The recovery time of spontaneous breathing, recovery time, extubation time and respiratory satisfaction time in the observation group were less than those in the control group ( P<0.05), and the VAS scores at 3 h, 6 h and 12 h after operation in the observation group were lower than those in the control group ( P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block combined with general anesthesia can effectively reduce the patient's stress response during laparoscopic cholecystectomy, with good analgesic effect, which is helpful to maintain the hemodynamic stability of patients.

The process of exercise regulating bone metabolism is complicated, which involves a number of signaling pathways. A large number of studies in vitro have indicated that mechanical stress regulates bone metabolism by Wnt, bone morphogenetic protein (BMP), and osteoprotegerin (OPG)/receptor activator of NF-κB ligand (RANKL)/receptor activator of NF-κB (RANK) signaling pathways. Both the in-tensity and frequency of mechanical stress have varing impact on bone tissue and cells. Plenty of studies in vivo also have shown that exer-cise regulates bone metabolism by key factors in bone metabolism signaling pathways. This paper reviewed the effects of exercise on bone metabolism pathways and their mechanisms.

Objective To study the correlation between expression of vascular endothelial growth factor(VEGF)and tissue inhibitor of metalloproteinase 2(TIMP-2)and prognosis of patients with laryngeal squamous cell carcinoma.Methods The expression of VEGF and TIMP-2 were measured in 38 specimen of LSCC and 19 specimens of normal laryngeal tissue adjacent to the tumors with EnVision immunohistochemical technique,follow-up for 3~5 years after operation local relapse occurred in four cases,cervical nodular metastasized occurred in fwo cases and pneumonic metastasis occurred one case.Results The expression level of two marks in primary tumors was significantly higher than that in pericancerous tissues(P

Objective To evaluate the effect of type Ⅱ odontoid fracture,type Ⅰ Hangman fracture,C2-C3 disc injury on stability of C1-C2 and C2-C3 segments and investigate the clinical significance.Methods Ten fresh-frozen cadaveric cervical specimens (5 men and 5 women; 25-45 years of age,mean 35.7 years) were selected to test the stability of C1-C2 and C2-C3 segments in the settings of intact condition (control group),type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury.Range of motion (ROM) and neutral zone (NZ) of those segments were measured.Results Compared with the intact condition,type Ⅰ Hangman fracture produced no significant variations in C1-C2 ROM in all loading modes and C2-C3 ROM during left and right lateral bending; type Ⅱ odontoid fracture produced no significant variations in C2-C3 ROM in all loading modes and C1-C2 ROM during left and right rotation; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture revealed no significant variations in C1-C2 ROM during left and right rotation and C2-C3 ROM during extention; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury produced no significant variations in C1-C2 ROM during left and right lateral bending and extension-flextion and C2-C3 ROM in all loading modes (P ＜ 0.05).Conclusions Type Ⅰ Hangman fracture can reserve C1-C2 segmental left and right rotation and extension-flextion; type Ⅱ odontoid fracture can reserve C1-C2 segmental left and right lateral bending and extension-flextion; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury can reverse atlantoaxial rotationary stability and C1-C3 segmental stability in all directions.This study provides the biomechanical basis for clinical treatments and the related researches of internal fixation.

Objective To investigate the association between the single nucleotide polymorphisms (SNP)in-308 loci of tumor necrosis factor-α(TNF-α)gene promoter region and chronic hepatitis B (CHB).Methods Genotypes of-308 loci of the TNF-αpromoter were examined by the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP)in 142 patients with chronic hepatitis B (CHB group)and 150 healthy controls (HC group).The indexes for evalua-ting the curative effect were the ALT,AST,HBeAg,HBV-DNA and the viral load weight,HBV-LP and HBV-PreS1,mean-while,the correlations between related indexes and SNP in TNF-α308 loci were explored as well.Results There was no sta-tistical significance in frequency distribution difference of the genotypes and alleles of-308 loci between CHC and HC groups (P>0.05),the protective factors of TNF-α308 allele A may be not associated with CHB (OR=1.529,OR95%CI:0.872~2.684).There was no association between TNF-αgene promoter-308G/A polymorphism and the positive rates of AST, ALT,HBV-LP and HBV-PreS1 (P>0.05),however,TNF-α-308G/A polymorphism associates with the positive rates of HBeAg and HBV-DNA,and A-allele of 308 loci may increase the risk of HBeAg and HBV-DNA positive expression (HBeAg:OR=3.256,OR95%CI=1.105~9.594;HBV-DNA:OR=2.847,OR95%CI=1.059~7.655).Furthermore,A-allele compared with Gallele,statistically significant differences were observed in the certain HBVDNA viral load range of104~107 copies/ml (P <005).Conclusion TNFαgene promoter308G/A polymorphism would not be associated withCHB,but the TNFα308 gene G mutation of Aallele,which was associated with HBVDNA viral load,may be the susceptible factors of HBV infection.

BACKGROUND:Studies have found that both bone marrow mesenchymal stem cels and umbilical cord mesenchymal stem cels have therapeutic effects on liver failure, but little is reported on adipose-derived mesenchymal stem cel transplantation for treatment of liver failure.
OBJECTIVE:To discuss the therapeutic effect of adipose-derived mesenchymal stem cel transplantation on rat liver failure.
METHODS: Forty-five Sprague-Dawley rats were equaly randomized into transplantation, model and control group. Except the control group, animal models of liver failure were made by intraperitoneal injection of D-galactosaminein in the transplantation and model groups. One week after modeling, rats in the transplantation group were given 1 mL of adipose-derived mesenchymal stem celsvia the tail vein.
RESULTS AND CONCLUSION:Adipose-derived mesenchymal stem cell transplantation successfully upregulated alanine aminotransferase and aspartate aminotransferase levels, and moreover, neatly arranged liver cells, reduced inflammatory cells and intact hepatic lobule were shown on B ultrasound after cell transplantation. All these findings indicate that adipose-derived mesenchymal stem cell transplantation has therapeutic effects on rat liver failure by improving rat’s liver function and pathological changes.

Aim To investigate the function of fenofi-brate on PAN ( puromycin aminonucleoside )-induced podocyte injury. Methods SD female rats of 18-week-old were randomly assigned into 3 groups ( n =6 ) . Mice in PAN group and fenofibrate treated group received a single intravenous injection of PAN ( 65 mg ·kg-1 ) , while those in control group received equal volume of saline. Mice in fenofibrate treated group re-ceived 40 mg · kg-1 · d-1 of fenofibrate ( intragastric administration ) on day 1 after PAN injection , while those in PAN group and control group received equal volume of vehicle. 24 hours urine samples from all group were collected on day 0(1 day before PAN injec-tion), day 6, day 10. The 24 hours urine protein was detected by Bradford assay. All the rats were sacrificed 10 days after the induction of podocyte injury, and glo-merulus sample were collected. The expression of podocyte injury marker and transcription level in apop-tosis, podocyte cytoskeleton protein, slit diaphragm protein were evaluated by Western blot and real-time PCR. Results Compared with the control group, 10 days after injection of PAN, 24 hours urine protein was obviously increased, and the expression and transcrip-tion level of podocyte injury marker desmin, apoptosis, podocyte cytoskeleton protein, slit diaphragm protein were upregulated greatly, however, those were signifi-cantly lower in fenofibrate treated group as compared with those in PAN group. Conclusions PPAR-α ago-nist fenofibrate can ameliorate PAN-induced glomerulus podocyte injury, and the mechanism involved may be associated with inhibition of the mitochondria apopto-sis, TGF-β/Smad pathway and p38 pathway.

Objective To investigate the clinical outcomes of pedicle screw fixation assisted with the 3D printing positioning guide template for treatment of unstable atlas fractures.Methods A retrospective case series review was made on 10 patients with unstable atlas fractures undergone direct posterior C1 pedicle screw fixation assisted with the 3D printing drill guide template from September 2012 to May 2015.There were 7 males and 3 females,with a mean age of 52.6 years (range,23-75 years).All patients complained of neck pain,stiffness and decreased range of motion without neurologic deficit.Preoperative skull traction was used routinely.After the three-dimension reconstruction of cervical vertebrae,ideal trajectory for C1 pedicle screws was designed with a complementary basal template for posterior surface of atlas corresponding anatomical structure.Then the drill guide template was materialized in a rapid prototyping machine and used during operation.Start point and direction of the ideal and actual trajectories were measured after matching the position of the pre-and post-operative patients' cervical spine.Safety of pedicle screw fixation was assessed in the transverse and sagittal planes of CT scan.Operation time and blood loss were recorded.Visual Analogue Scale (VAS) of neck pain was recorded before operation and 3 months after operation.Clinical efficacy,fracture reduction,stability and surgical complications were reviewed at the follow-up.Results A total of 20 screws were inserted safely.No significant differences existed in deviation of entry point and direction between ideal and actual trajectories (P ＞0.05).Operation time was 60-90 min (mean,75 min) and intraoperative blood loss was 110-300 ml (mean,160 ml).No spinal cord or vertebral artery injury was noted during operation.All patients were followed up for 12-36 months (mean,20.5 months).VAS was improved from preoperative 7.3 (6.3-9.5) points to 1.4 (0.3-2.5) points 3 months after operation (P ＜ 0.05).All patients had normal range of motion of the cervical spine 3 months after operation.Bony fusion was achieved 6 months after operation.At the follow-up,good cervical alignment was maintained with no instrument failure and C1.2 instability.Conclusion For treatment of unstable atlas fractures,direct posterior C1 pedicle screw fixation assisted with the 3D printing drill guide template can improve the precision of screw placement,reduce complications,and preserve the function of the occipital-atlantoaxial junction.

Objective To investigate immunological changes in the serum of elderly patients with primary nephrotic syndrome (PNS).Methods We made a retrospective analysis of clinically relevant immunological parameters and pathological data of PNS patients 60 years old and above (elderly group)in our hospital for kidney biopsy between September 2010 and November 2013.The data of similar patients but younger than 60 years old (control group)were collected for comparison.Results ① The average levels of IgG in serum of the two groups were both lower than the normal level.And the patients with a decreased level accounted for 59.3% in the elderly group and 78.2% in the control group.The results exhibited a significant difference (P <0.05).The elderly group had higher proportions of IgA level in the serum and IgA and IgG/IgM ratio than the control group.The level of IgM in the aged patients,however,was significantly lower than that in the control group (P <0.05 ).The mean concentrations of C3 and C4 in the serum were both in the normal range,and no significant difference was observed (P >0.05).③ IgG had a negative correlation with urinary protein and cholesterol in serum (the values of r were-0.107,-0.238,respectively,P <0.05).However,there was a positive correlation between IgG and albumin (r=0.252,P <0.05).The results in both groups were consistent.④ Membranous nephropathy was the most common pathological type in aged patients while in control group IgA nephropathy was the most common.Conclusion ① The level of IgG in the serum decreases in most aged patients with PNC.The serum IgA and IgG/IgM ratio are elevated while concentrations of C3 and C4 change little.②The change of IgG is correlated with urinary protein, serum albumin and cholesterol in aged patients with PNS.