Objective:Raise the diagnosis and treatment level of laryngeal closed trauma.Method:Analyze and discuss some problems of diagnosis or treatment through five cases reports.Result:Except clinical signs and symptoms,fibrolaryngoscopy and CT or MRI imaging examination should be used. According to it,make the injury degree of intralaryngeal structure and decide the management principle.Conclusion:Corrective diagnosis and treatment in emergency period was the key to raise curative effect in the near future and to prevent laryngeal stenosis in late period.

Objective:To determine the expression and localization of tumor necrosis factor alpha(TNF-α) in human middle ear cholesteatoma and its effects on bone resorption.Method:The distribution of TNF-α in 18 cholesteatoma tissues and 8 normal external ear canal skin, facial skin and tympanic memebrane were studied immunohistochemically with paraffin-embedded sections.Result:TNF-α was localized in the epitheliun and connective tissue of cholesteatomas studied, particularly on basal and spinous cells and macrophages.The epithelium of normal external ear canal skin , facial skin and tympanic membrane was slightly stained.Conclusion:This study revealed significantly increased level of TNF-α in cholesteatoma tissues.TNF-α acts both directly,by causing bone erosion as an autocrine growth factor,and indirectly as an important mediator by stimulating the release of enzymes causing bone destruction.

Objective To summarize the experience in the diagnosis and management of complicated esophageal foreign bodies. Methods A retrospective study was conducted in 64 patients with complicated esophageal foreign bodies from January 1994 to July 2004 in this hospital. Types and location of foreign bodies ingested were analyzed. Results Animal bones accounted for 50% of foreign bodies ingested (32/64) and foreign bodies located at the esophageal inlet in 68.75% of the patients (44/64). Dental prostheses ingestion (30 0%) and the impaction at the level of the second esophageal constriction (43 3%) were more encountered in the middle-to-old aged patients than in patients under the age of 50 ( P

Objective: To verify the hypothesis that cells with characteristics similar to bone marrow mesenchymal stem cells(MSCs) can be isolated and cultured from human fetal articular cartilage. Methods: Human fetal articular cartilages were harvested from fetuses aborted between 12 and 20 weeks. Cells were grown in monolayer cultures in IMDM medium containing antibiotics, L-glutamine and fetal calf serum. Cells were induced to differentiate into adipocytes, osteoblasts, chondrocytes, and neurons. At various time points, parental and passaged cells were subjected to FACS analysis to determine cell phenotype. Results: We successfully isolated and cultured MSCs from human fetal articular cartilage. These cells had the same morphology, phenotype, and ability to differentiate in vitro as MSCs of bone marrow origin. Conclusion: This study shows that cells with characteristics of MSCs can be isolated and cultured from human fetal articular cartilage.

A case of arginine vasopressin receptor 2 ( AV PR2 ) mutation in a boy with congenital nephrogenic diabetes insipidus was reported.Genomic DNA of the boy and his family members was extracted.The entire coding region of the AVPR2 gene were amplified by PCR.The amplified products were purified and sequenced.The results were compared with the normal one of the gene bank.The impact of the mutation on AVPR2 structure was discussed with respect to homology structure model.The analysis identified a T to G transition in exon 2 of the AVPR2 gene,resulting in substitution of leucine for arginine at amino acid residue 168.Furthermore,the patient′s mother and sister were heterozygous for this mutation,and the father was normol.

Objective To explore clinical value of cardiac MRI feature tracking (CMR-FT) in evaluation of left ventricular global and regional myocardial strain in hypertrophic cardiomyopathy (HCM).Methods Totally 60 patients with HCM (HCM group) and 10 healthy volunteers (control group) were enrolled and underwent cardiac MR.MR Sequences included fast imaging employing steady state acquisition (FIESTA) and late gadalinum enhancement (LGE) at ventricular short-axis,two-chamber and four-chamber planes.The patients in HCM group were divided into LGE negative subgroup and LGE positive subgroup.CMR-FT processing software was used to measure myocardial global radial peak strain (GPSR),global circumferential peak strain (GPSC) and global longitudinal peak strain (GPSL).The radial,circumferential and longitudinal peak strain (PSR,PSC and PSL) at the apex,middle and basal parts of left ventricular were also measured as well.Resuits GPSR,GPSC,GPSL in LGE positive subgroup,LGE negative subgroup and control group had significant differences (all P＜0.05),and showed upward trends.Except PSL at the apex had no significent difference among three groups,PSR,PSC and PSL at the apex,middle and basal parts had significant differences (all P＜0.05),and also showed upward trends.There were positive correlations between the LVEF,SV and GPSR,GPSC,GPSL (all P＜0.05).The area under ROC curve of GPSR,GPSC and GPSL in diagnosis of HCM were 0.79,0.82,0.77 (all P＜0.05),and the area under ROC curve of GPSC was the largest.Conclusion The CMR-FT technology can find myocardial strain dysfunction in HCM sensitively,and the longitudinal strain is damaged earlier or worse than circumferential and radial strains.

OBJECTIVE To understand what role of the L-type calcium channels play in the mechanism of salicylate-induced tinnitus. METHODS The effects of salicylate on L-type calcium channels in freshly dissociated inferior colliculus neurons of rats were studied using the whole-cell voltage clamp method. RESULTS Salicylate blocked L-type calcium channel current (ICa,L) in concentration-dependent manner. The half-blocking concentration of salicylate was 1.99 mmol/L. Salicylate did not affect the conductance-voltage curve and the steady-state activation curve of ICa,L, shifted the steady-state inactivation curve of ICa,L by about 8 mV in the hyperpolarizing direction, and delayed the recovery from inactivation of ICa,L. CONCLUSION Our results suggest that salicylate’s blocking of L-type calcium channels may contribute to salicylate-induced tinnitus by decreasing the release of ?-aminobutyric acid in the inferior colliculus.

Objective To investigate the effect of intracranial pressure fluctuation on the prognosis of patients with traumatic brain injury (TBI).Methods A retrospective case series study was conducted on the clinical data of 30 patients with TBI hospitalized between June 2012 and June 2014.There were 21 males and 9 females,aged (43.0 ± 19.8) years.After the intracranial pressure probe was implanted,the intracranial pressure of TBI patients was monitored continuously and the data were recorded per minute.A single cosine method was used in analyzing the circadian rhythm of intracranial pressure data.Furthermore,the ratio of the amplitude of the circadian parameter (A) to the median (M) value (A/M) was selected to evaluate the biologic rhythm of patients.The correlations of circadian rhythm parameter A/M with Glasgow Outcome Scale (GCS) and with extended Glasgow Outcome Scale (GOS-E) were analyzed using linear regression.Results The circadian rhythm was observed in all patients regardless of injury severity (P ＜ 0.01).The circadian rhythm parameter A/M of intracranial pressure was positively correlated with the GCS of patients at discharge (R2 =0.346,F =14.797,P ＜0.01) and with the GOS-E (R2 =0.356,F =15.502,P ＜ 0.01).Conclusion The intracranial pressure fluctuation of TBI patients follows circadian rhythm,which might be correlated with the prognosis of TBI patients.

Post-traumatic hydrocephalus (PTH) is one of the common secondary lesions after severe craniocerebral injury.Shunt surgery is the most important surgical treatment in clinic.There are many kinds of shunt methods,but there is no uniform standard for method selection.Lumboperitoneal shunt (LP),as an important alternative operation,has gradually become one of the mainstream shunt operations.This article reviews the new operative indications of LP,the advantages of LP over traditional ventriculoperitoneal shunt (VP),the latest preoperative evaluation system and preoperative evaluation score of Huaxi LP,the technical points of LP operation,follow-up key points,common postoperative complications and management,so as to provide reference for exploring better technical routes and operative concepts of LP.

Objective: To investigate the application value of cardiovascular magnetic resonance tissue-tracking (CMR-TT) in the quantitative assessment of global and segmental myocardial strain after myocardial infarction. Methods: From June 2013 to June 2017, 45 patients with chronic myocardial infarction from the Second Affiliated Hospital of Nanchang University and eighteen normal volunteers as a control group were included in our research. All participants received CMR examination on a 3.0 T MRI scanner. Imaging protocol including FIESTA cine sequence (left ventricle short-axis planes, four chamber and two chamber long-axis planes) and late gadolinium enhancement (LGE). CMR-TT was undertaken using cvi 42 dedicated commercial software, global peak systolic circumferential, longitudinal, radial strains (GPCS, GPLS, GPRS) and segmental peak systolic circumferential, longitudinal, radial strains (PCS, PLS, PRS) in accordance with the American Heart Association's sixteen segment model were all derived. All segments were divided into five groups according to transmural extent expressed as enhanced area per segment: 0% as non-LGE segments group, 1 %-25 % as mild LGE segments group, 26%-50 % as moderate LGE segments group, 51%-75% as severe LGE segments group and >75% as complete LGE segments group. Two-independent samples t-test and Kruskal-Wallis H test were used, respectively, to compare means of 2 and 3 or more groups of continuous variables. Variables with normal distribution were presented as ±s, non-normal variables were reported as median (interquartile range). Results: Patients showed significant lower GPRS, GPCS and GPLS than the control group (15.13%±8.18%, -8.25%±3.23%, -7.11%±2.41% versus 32.41%±12.99%, -14.92%±3.32%, -11.50%±2.51%). PRS, PCS and PLS statistically significantly decreased with increasing extent of myocardial enhancement (t=-6.35,7.33,6.44, P<0.001).Segmental peak systolic strains of five groups were:PRS:24.87% (10.95%,39.02%), 13.26%(5.94%,24.24)%, 9.47%(4.01%,18.40%), 5.98%(-3.74%,11.86%), -2.65%(-6.62%,8.59%), respectively; PCS: -11.84%±5.34%, -8.60%±5.48%, -7.32%±5.59%, -5.30%±5.52%, -2.74%±5.24%, respectively; PLS: -9.47%±6.82%, -7.72%±6.22%, -7.07%±6.49%, -5.55%±5.95%, -3.54%±5.44%, respectively. The differences in the groups were statistically significant (H=164.47,166.61, 59.06, P<0.001). GPRS was positively correlated with LVEF(r=0.543, P<0.001), while GPCS and GPLS were both negatively associated with LVEF (r=-0.654, P<0.001; r=-0.682, P<0.001, respectively). Conclusions CMR-TT can quantitatively assess the severity of myocardial infarction accurately and reliably.Strain parameters have a good correlation with cardiac function indexes, this may be helpful in the recognition of left ventricular remodel after MI.