Fifty-one cases of labyrinthine fistula had been reviewed in 1990-1997 during chronic ear surgery. All cases had a lateral semicircular canal fistula and one case had an additional posterior semicircula canal fistula. There was no relationship between the size of labyrinthine fistula and preoperative bone conduction. 34 cases had chronic otitis media with cholesteatoma,the matrix of the cholesteatoma was completely removed in all patients except one case. Preoperative bone conducton hearing was preserved after removal of cholesteatoma matrix in all cases except the one case.

Stricture and insufficiency of eustachian tube in 43 cases were treated by floating duct for dilation of eustachian tube under fiber endoscopy. Clinical observation lasbed 2-10 months. 23 cases were significantly effective, 13 cases effective. No intraoperative complications.

Objective To observe the effect of Tongguanluo capsule in treating oviduct obstructive infertility and analyze the potential mechanism. Methods 106 patients with oviduct obstructive infertility were randomly divided into the observing group and the control group, 53 cases of each group. The observing group was treated by Tongguanluo capsule and the control group was treated by Huoxue Huayu Capsule. The effects were compared after 4 weeks. Results For observing group and control group respectively, the re-opening rates were 97.0% and 75.9% (P

To discuss the value of the diagnosis and treatment for the submucous myomas by hysteroscope. According to the data of hysteroscopic resection in the treatment of submucous fibroids, the authors suggested that the submucous myomas should be divided into four types and the detailed appearance of each type were discussed. Conclusions: Four types of the submucous myomas were distinguished and the surgical treatment of each type were chosen correspondingly under hysteroscope.

To analyze the pathogenesis, clinical symptoms, misdiagnosis and operation of endometriosis in unusual sites,32 cases of unusual site endometriosis were analyzed. 468% was correctly diagnosed before operation,and 625% was found to have a history of operation.Good prognosis can be achieved by combined treated on the basis of discussing its pathogenesis clarifying its increasing incidence rate,and attaching importance to its malignant tendency.

Objective To investigate CT findings of atypical pheochromocytoma.Methods 18 cases of atypical pheochromocytoma were verified with operation and pathology.2 cases were extra-adrenal pheochromocytoma,3 cases were bilateral or multiple pheochromocytoma,7 cases were non-function pheochromocytoma and malignant pheochromocytoma were 6 cases.Results All atypical pheochromocytoma showed equivalent density mass with necrosis in CT scanning,calcification was rare.Most of them had strong enhancement in parenchyma.Conclusion (1)Atypical pheochromocytoma has high tendency to malignance.(2)CT has high locational and qualitative rate in diagnosing atypical pheochromocytoma but can not different malignance from benign pheochromocytoma,except the mass has metastatic signs.The diagnosis of non-function pheochromocytoma has to consider biochemical and other examination.

Objective To investigate CT features of adrenal neoplasms.Methods 9 cases of rare adrenal neoplasms were verified with operation and histology.3 cases were ganglioneuroma,2 cases were neuroblastoma and the remaining four were cyst,neurofibroma,lipoma and mesenchymoma.Results Adrenal cyst,neuroblastoma and lipoma had their obvious CT features.All adrenal ganglioneuroma,neurofibroma and mesenchymoma had low or equivalent density.Ganglioneuroma and neurofibroma had no enhancement but mesenchymoma had slight or moderate enhancement.Conclusion It is difficult or impossible to distinguish these tumors,except cyst,neuroblastoma and lipoma,from non-function adenoma or pheochromocytoma.

Objective The study was designed to evaluate the clinical efficacy of azithromycin in lung function of patients with IPF.Methods Randomized controlled trials were searched in CNKI,data-base of Wanfang and WeiPu,where azithromycin was used to patients with IPF.We extracted all data on lung functions,standardized mean difference (SMD)with 95% confidence intervals (CI )were pooled with Stata 11.0.Results Seven unique trials with 516 participants were identified.Be compared to pred-nisone,the patients with IPF received azithromycin experienced no improvement in FVC% [SMD = -2.00,95% CI =(-2.05,-1.95)],but it was found that azithromycin was superior to prednisone in in-crease the percentage of carbon monoxide diffusing [SMD =1.16,95% CI =(-2.83,5.16)]and de-cline the percentage of residual volume[SMD =3.00,95% CI =(1.04,4.96)].Azithromycin combined with prednisone were statistically superior to prednisone alone in improvement of FEV1 %[SMD =7.80, 95% CI =(5.92,9.67)],FVC%[SMD =7.23,95% CI =(4.89,7.56)]and lung carbon monoxide diffusion function[ml/(min·kpa))][SMD =40.62,95% CI =(38.96,42.28)].Conclusions Our study suggests that azithromycin significantly improvement pulmonary diffusion function in patients with IPF. Azithromycin combined with prednisone were more effective in improvement of FEV1 %,FVC% and lung diffusion function.

Objective To study the effects of enteral nutrition( EN) on inflammatory factors and cardiac function in elderly patients with heart failure ( HF ) . Methods A total of 96 elderly patients with HF were enrolled in this study and randomly divided into treatment group A,treatment group B and control group( n= 32 in each group) . Patients in group A were provided with 500 mL of EN daily for 1 month, and those in group B were provided with the same dose of EN for 3 months. Control group was treated with normal diet. The nutrition status of each group was assessed by NRS2002. Meanwhile,all patients were evaluated by New York Heart Association(NYHA) class and left ventricle eject fraction(LVEF). The levels of BNP,IL-6, CRP and TNF-α were also measured before and after nutrition treatment. Results In group A and group B,BMI,TSF,AMC, TP,ALB and HGB increased. Symptoms of HF alleviated quickly and LVEF increased compared to the baseline. The levels of BNP,IL-6,CRP and TNF-α were significantly lower after treatment(P<0. 05) in both treatment groups,and the change in group B was more obvious(P<0. 01) than group A. However,in control group,there is neither evident improvement in cardiac function or nutrition status,nor in inflammatory factor levels. Conclusion Adding EN support to the normal treatment of heart failure in elderly malnourished patients with HF not only improves the function of heart and nutrition status, but also helps to support immune system so as to alleviate acute inflammatory response. The benefits from EN depend on the duration of therapy.

Objective To compare the effectiveness and safety of Foley catheter(FC)and vaginal prostaglandin E2 suppository(PGE2,Propess)for cervical ripening and labor induction in fullterm pregnant women with unfavorable cervix.Methods A prospective randomized controlled trial was conducted.Women with a term or post-term,live,singleton fetus in cephalic presentation,intact membranes,Bishop score＜6,not in labor,medically indicated for labor induction from June 2009 to December 2009 in Drum Tower Hospital of Nanjing University Medical School were randomly divided into two groups:FC group(n=64)and Propess group(n=62).In FC group,a 16-F Foley catheter was inserted into patient's cervical canal; once past the internal os,the balloon was inflated with 80 ml saline.Intravenous oxytocin was initiated after the balloon was spontaneously extruded from the cervix or after 24 hours.In Propess group,vaginal Propess was used.x2 or Fisher's exact test and t test were used to compare the outcomes,delivery mode and induction success rate between the two groups.Results There were no significant differences in gestational weeks,Bishop score,indication of induction,improvement of Bishop score,success rate of induction,rate of vaginal delivery,total duration of labor and volume of postpartum hemorrhage between the two groups(P ＞ 0.05,respectively).Propess group had a higher rate of vaginal birth within 24 hours[56.5％(35/62)vs 28.1％(18/64),t=10.37,P＜0.05],a higher risk for excessively frequent and hard uterine contraction[17.7％(11/62)vs 0.0％(0/64),P＜0.05]and lower incidence of oxytocin induction/augmentation during labor[21.0％(13/62)vs 87.5％(56/64),x2 =56.27,P＜0.05]than those of FC group.There were no differences in neonatal Apgar score,meconium staining and neonatal birth weight between the two groups.Puerperal infection occured in neither group.Conclusions Under strict control of indication and aseptic manipulation,Foley catheter was as effective and safe as Propess for cervical ripening with lower risk of excessive uterine activity.It is suggested that Foley catheter could be used for cervical ripening,especially in patients with economic difficulty.