[ABSTRACT]OBJECTIVETo investigate the treatment choice and curative effect of stage III external auditory canal cholesteatoma (EACC) with different degrees of damage to the posterior wall of external auditory canal and mastoid.METHODS44 patients (45 ears) diagnosed with III type external auditory canal cholesteatoma and treated with different surgeries were collected: 27 ears with damages of mastoid which did not involve tympanic antrum (group A) underwent simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). 18 ears with damages of mastoid which involve the tympanic antrum (group B) underwent mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty. RESULTSAll patients were followed up for 1 to 2 years postoperatively. There was no recurrence of cholesteatoma, no external auditory canal collapse, stricture or atresia,and hearing improved to different degrees. The postoperative dry ear rate of group A and group B was 100% and 94.4% respectively. The mean duration of dry ear in group A and B was (12.1±2.3) and (28.1±3.5) days respectively. The cases with smooth external auditory canal and good self-purification in group Aand B accounted for 100% and 88.9%respectively.CONCLUSIONType III external auditory canal cholesteatoma can be treated with different surgical methods according to different damages of mastoid. The cases in which damages of mastoid did not involve tympanic antrum can be treated with simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). The cases in which damages of mastoid involved tympanic antrum can be treated with mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty.

OBJECTIVE: To explore the clinical manifestations and treatments of retro-esophageal space abscess. METHOD: The clinical data of 27 cases with retro-esophageal space abscess were analyzed retrospectively. Twenty-one cases (77. 78%) were secondary to acute injury of esophageal meatus caused by foreign bodies. 2 cases (7. 41%)were secondary to old foreign body infection in retro-esophageal space, 3 cases (11. 11%) after secondary to pharyngeal abscess, and 1 case (3. 70%) was unknown to etiology. All patients were confirmed by sectional medicalimageology. Six cases(Conservation group, C group) were treated conservatively and 6 cases (Oropharyngeal incision group, OI group) were performed with oropharyngeal incision drainage. 15 cases(Extra-neck incision group, ENI group)were performed with extra-neck incision and vacuum sealing drainage. RESULT: In C group, 6 cases were cured with conservative therapy and the average hospital stay was 15. 6 days. In OI group, 5 cases were healed with oropharyngeal drainage but aspiration pneumonia complicated with septic shock occurred in 2 cases, and 1 case dead from septic shock secondary to mediastinum and lung abscess. The average hospital stay was 18. 8 days. In ENI group, 15 patients were cured with extra-neck drainage without complication and the average hospital stay was 9. 5 days. CONCLUSION The main causes of retro-esophageal space abscess are foreign body injury of upper esophagus and remnant of retro-esophageal space. Sectional medicalimageology can be of important value of diagnosis and treatment for displaying the retro-esophageal space abscess and other deep cervical fascia space sufficiently. Incision and vacuum sealing drainage via extra-neck is an effective therapy while oropharyngeal drainage is less effective and is not advocated as a primary treatment because of aspiration pneumonia complication . Conservative cure is a choice for patients without dyspnoea and background diseases, and it is necessary to recognize and treat severe complications early.
Abscess ; etiology ; therapy ; Drainage ; Esophagus ; Foreign Bodies ; complications ; Humans ; Neck ; Pharyngeal Diseases ; Retrospective Studies

Objective To investigate the clinical effect of myringoplasty with double flaps in treatment of large tympanic membrane perforaton.Methods Ninety-five patients (112 ears) with large tympanic membrane perforation were enrolled in this study,48 patients (54 ears) were performed myringoplasty with double flaps (double flaps method group) and 50 patients (58 ears) were performed myringoplasty with underlay method (underlay method group).The air conduction (AC) and air bone gap (ABG) were measured before operation and 6 months after operation.The clinical efficacy of two groups was compared.Results The successful rate in double flaps method group was 96.3％ (52/54) and 91.4％ (53/58) in underlay method group,there was no significant difference (P ＞0.05).The effective rate in double flaps method group was 92.6％ (50/54) and 77.6％ (45/58) in underlay method group,there was significant difference (P ＜ 0.01).Conclusions Myringoplasty with double flaps in treatment of large tympanic membrane perforation can effectively mould tympanic membrane and improve hearing.The operation is worthy of spreading.

Brucella organisms are facultative intracellular bacteria capable of surviving inside professional and non-professional phagocytes.Upon cell contact the bacteria is internalized via receptor molecules.Once inside cells,Brucella localizes in early phagosomes,where it avoids fusion with late endosomes and lysosomes.Then,the bacterium redirects its trafficking to autophagosomes and finally reaches the endoplasmic reticulum,the replicating niche.Once inside the endoplasmic reticulum,Brucella extensively replicates without restricting basic cellular functions or inducing damage to cells.Invasion,intracellular trafficking and replication of Brucella organisms in professional and non-professional phagocytes and the molecular determinants involving Brucella intracellular life are reviewed in this article.

Animals ; Genes, BRCA2 ; Genes, erbB-1 ; Genes, erbB-2 ; Genes, p16 ; Genes, p53 ; Genes, ras ; Genetic Predisposition to Disease ; genetics ; Humans ; Pancreatic Neoplasms ; classification ; genetics ; pathology

Objective To evaluate the association between methylenetetrahydrofolate reductase gene (MTHFR) C677T polymorphism and diabetic kidney disease in Chinese population.Methods After searching the related literatures from PubMed,Medline,EMBASE databases and common Chinese journal literature databases,meta-analysis was performed to assess the association of MTHFR C677T polymorphism with diabetic kidney disease according to the principles of systematic review based on the recessive model and dominant model respectively.Fixed effect model (M-H) was used to pool odd ratio (OR) after heterogeneity test.The Begg and Egger analysis were conducted to evaluate the publication bias.Results 10 literatures including a total of 2018 cases were included in the metaanalysis.No significant heterogeneity was detected.Data were pooled by fixed effect model.The total OR was 2.41 (95％CI=1.85～3.13) and 2.33 (95％CI=1.82～2.98) in recessive and dominant models respectively.No obvious publication bias was observed by Begg and Egger analysis.Conclusions The T allele of C677T polymorphism in MTHFR gene is positively associated with diabetic kidney disease in Chinese population.

OBJECTIVETo determine the expression of bone morphogenetic protein 2 and 4 (BMP-2 and BMP-4) in prostatic carcinoma (PCa) and investigate their relationship with clinical stage and Gleason score of tumor.

METHODSForty-eight PCa cases and 5 normal prostatic tissue were analysed for the expressions of BMP-2 and BMP-4 by Western bolt assay.

RESULTSThe optical densities of BMP-2 expressions in the tumor with Gleason score < or =5, 6-8, and > or = 9 were 7547.1 +/- 1964.12, 9657.4 +/- 2010.54, 12467.7 +/- 2496.75 and of BMP-4 expressions were 5174.4 +/- 1400.54, 5940.3 +/- 1587.42, 6332.1 +/- 1647.83, respectively. The optical densities of BMP-2 expressions in the tumor in T1 - T2 and T3 - T4 stages were 8003.37 +/- 1889.23, 12385.55 +/- 2506.72 and of BMP4 expressions were 5267.41 +/- 1 464.19, 6543.75 +/- 1668.46, respectively. There were significant differences between tissues with Gleason score < or =5 and > or =9 (P <0.01), and tissues in T1 - T2 and T3 - T4 stages, in expressions of BMP-2 protein. The expression of BMP-2 protein was significantly high in the PCa with bone metastasis compared with that without bone metastasis.

CONCLUSIONThe expressions of BMP-2 and BMP-4 increase with the progression of clinical stage and Gleason score compared with normal prostatic tissue. The expression of BMP-2 protein is significantly upregulated in bone metastasis of PCa, which indicates a poor prognosis.

Aged ; Aged, 80 and over ; Blotting, Western ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Protein 4 ; Bone Morphogenetic Proteins ; biosynthesis ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prostate ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology ; Transforming Growth Factor beta ; biosynthesis

Objective To set up a new method,which is sensitive,low cost,rapid and suitable for clinical application for FTO gene rs9930506 variant genotyping basing on high resolution melting (HRM) platform,and to preliminarily put into practice in susceptibility analysis for metabolic syndrome (MS) in Beijing.Methods Unlabelled probe with C3-spacer block specific for rs9930506 variant has been designed according to the Refseq from GenBank.With LC-Green plus dye pre-mixed,we scanned the signal for the genotype analysis after PCR amplification and HRM reaction.Restriction fragment length polymorphism (RFLP) and PCR-sequencing methods were designed as 2 control genotyping methods for the evaluation of accuracy and convenience.Afterwards,the HRM-based method was put into practice in metabolic syndrome patients (n =500) and control groups (n =500) for rs9930506 genotyping,and primarily study the association between rs9930506 and MS.Results All the 3 methods could genotype rs9930506 appropriately,although the 2 control methods seemed to be a little time-inefficient.The call rate of HRM-method was 100％ and sampling accuracy reached 99.3％ according to sequencing results.In the MS group,AA,AG and GG genotypes were found in 290,185 and 25 cases,respectively.And in the control group,those were found in 344,138 and 18 cases.No genotype distribution difference was detected between control group and HapMap-CHB data (P =0.520 ).The genotype distributions were all in Hardy-Weinberg equilibrium in each group.AA genotype of rs9930506 seemed to reduce the risk for MS( OR =0.626,95％CI =0.483-0.812).Conclusions The AA genotype of rs9930506 variant in FTO might be a protective factor for MS in Beijing population.The susceptibility related genotyping in clinical samples could be more rapid,precise and inexpensive with the development of HRM in genotyping.

Objective To explore a method for isolation and culture of human epidermal stem cells. Methods Epidermis was obtained by digesting human foreskin with Dispase Ⅱ and Trypsin-EDTA.After suspension on the epidermal stem cell medium (ESCM), these single epidermis cells were inoculated onto human collagen Ⅳ-coated flasks and cultured at 37 ℃ in a humidified atmosphere containing 5% CO_2 for 10 min. The nonadherent cells were rinsed off 10 min after inoculation, and the adherent cells continued to be cultured after enriching and abstraction by type Ⅳ collagen. The cell growth was observed through inverted microscope, and the cell cloning efficiency and time of clone sustain were also detected. Immunocytochemistry was used to observe the expression of ?_1-integrin and keratin 19(K19). Keratinocytes were served as controls. Results It was revealed by histological observation that colonies were formed 24 hours after inoculation. The isolated and cultured cell cloning efficiency was higher and the time of clone sustain was longer than that of the control group. Positive expression of ?_1-integrin and K19 of cultured cells was detected by immunocytochemistry. Conclusion Adult epidermal stem cells could be successfully isolated and cultured by adhension with type Ⅳ collagen and culture with ESCM.

ObjectiveTo study the correlation of urinary iodine and thyroid function in elderly men in Harbin,and to provide the basis for formulation of health measures for the elderly.MethodsSeventy five cases of clinically healthy elderly men were enrolled for check-up of urinary iodine,thyroid function and B-ultrasound in Geriatric Ward the Forth Affiliated Hospital of Harbin Medical University in 2010.The subjects of investigation were divided into iodine appropriate and iodine sufficient groups and thyroid function parameters and B-ultrasound results were compared.ResultsThe average age of the 75 cases of healthy elderly men was (79.07 ± 4.78) years old and the median of urinary iodine was 198.4 μg/L.There were 62.67％ (47/75) elderly males whose iodine nutritional status was appropriate,but there were still some individuals(6.67％,5/75) in the iodine excess state.The level of TSH of the iodine appropriate group [(1.91 ± 0.82)mU/L] was lower than that iodine sufficient group [(4.98 ±0.60)mU/L,t =12.58,P ＜ 0.05],while the level of FT3 of the iodine appropriate group[(4.71 ± 0.56)pmol/L]was higher than that iodine sufficient group[(3.31 ± 0.43)pmol/L,t =12.18,P ＜ 0.05].But the difference of FT4between the two groups [(14.91 ± 3.12),(14.06 ± 2.79)pmol/L] was not statistically significant (t =1.40,P ＞0.05].The thyroid volume of iodine sufficient group[(20.9 ± 6.1 )cm3] was higher than that iodine appropriate group [(17.9 ± 5.6)cm3,t =2.11,P ＜ 0.05].ConclusionsSufficient quantities of iodine intake may affect the thyroid of elderly people.Whether the quantity of iodine intake of the elderly population should be decreased or not need to be further studied.