BACKGROUND: Old people above 80 years old have a high incidence of dizziness and tumble, which are associated with weakening vestibular function, balance function and optokinetic function.OBJECTIVE:This study was designed to make a quantitative evaluation of vestibular function,balance function and optokinetic function in people over 80 years old.DESIGN:It was a quantitative study on posture function(vestibular and balance function),auditory function(frequency audiometry)and visual function (optokinetic function) in elderly persons.SETTING:Department of Otolaryngology ,General Hospital of Chinese PLA.PARTICIPANTS:Totally 41 old male inpatients with systemic diseases in Rehabilitation Department of the General Hospital of Chinese PLA, with an age from 80 to 94 were selected from March 1993 to January 1994.Of them,12 had tinnitus,20 had dizziness.During the same period,old cadres including 11 males and 7 females aged from 60 to 79 years with normal findings of physical examinations were selected as controls. No participant in this group suffered from tinnitus, deafness and dizziness. All the participants were voluntary.METHODS: Patients underwent full-scale otolaryngological examinations.Audiometry consisted of battery of tests including frequency audiometry and evoked auditory brainstem responses(ABR). Vestibular function (posture) was assessed by vestibular-ocular reflexes. Participants accelerated from 1 /s to 90 /s. Then, the angular speed was kept until the nystagmus disappeared,at the time a sudden stop was made.Changes in nystagmus during the tests were recorded.The eyes firstly turned to left and 10 minutes later turned to right.Slow-phase angular velocity was recorded and the imbalanced left/right rate was calculated.Vestibularspinal reflex (VSR) was measured using balance beam and the length of the sway of the center of gravity (CG) and the sway velocity of CG were all calculated. Balance tests using a cursor were employed to examine the central optokinetic system, including sweeping, tracking, and optokinetic responses.MAIN OUTCOME MEASURES: Frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were examined to assess the posture function, auditory function and visual function in elderly persons over 80 years old.And the results were compared with those of balance function tests and visual function tests in old population aged from 60 to 79 years old.RESULTS:Practically,the number of old participants over 80 years old receiving the tests of frequency audiometry, vestibular-ocular reflexes, and vestibular-spinal reflex and optokinetic responses were 41,24,39,40 and 34 respectively;The number of 60-79 participants receiving balance tests and visual tests were 18 and 10.Individuals refusing to participate were omitted. ① Auditory function:In 41 elderly persons ＞80 years,13 ears (16％) had a normal middle frequency audiometry, 69 ears (84％) had a loss of hearing. ② Posture function: 15 (62％) had normal vestibular-ocular reflexes, and 9 (38％) had abnormalities in vestibular-ocular reflexes.Ten (26％) had a normal vestibular-spinal reflex and 29 (74％) had an abnormal vestibular-spinal reflex.③ Balance function:Of all the variables of balance function,the length of the sway of CG and the sway velocity of CG were most valuable. In populations in both brackets, the length of the sway of CG and the sway velocity of CG in eyes-closed condition were longer and faster than those in eyes-opened .condition (P ＜ 0.01). In over 80 years group,the length of the sway of CG and the sway velocity of CG were longer and faster than in 60-79 group (P ＜ 0.01). ④ Optokinetic responses:Optokinetic plus were not obviously different between over-80 group and 60-79 group (P ＞ 0.05) and the latent period of sweeping and the distortion of tracking were significantly longer and greater in former group than in later(P ＜ 0.05-0.01 ).CONCLUSION:Most of the elderly persons over 80 years have a decrease in auditory and posture functions.Their optokinetic and balance functions are degenerated more severely than 60-79 years old population.

Objective To evaluate the value of low dose multilayer spiral CT (MSCT) threedimensional reconstruction in diagnosis of children tracheobronchial foreign body.Methods Forty-three children with tracheobronchial foreign body which was confirmed by fiberoptic bronchoscopy were enrolled,and all of the children underwent low dose MSCT three-dimensional reconstruction.The volume data were reconstructed on work station (Siemens) with the techniques of multiple plane reformation (MPR),curved planar reconstruction (CPR),minimum intensity projection (MinIP),volume rendering (VR),CT virtual bronchoscopy (CTVB),and the results of MSCT were compared with fiberoptic bronchoscopy.Results The fiberoptic bronchoscopy results were used as the localization and qualitative diagnosis results.Locations of the foreign body were trachea and bifurcation of trachea (6 cases),right bronchus (23 cases) and left bronchus (14 cases),and the coincidence rate of localization diagnosis of MSCT was 100％ (43/43).Natures of the foreign body were nuts in 21 cases,beans in 5 cases,corn in 2 cases,fruits and vegetables in 6 cases,and other kinds in 4 cases.Qualitative diagnosis by MSCT was medium density foreign body,and the coincidence rate was 100％ (38/38).Five cases had bone mass,qualitative diagnosis by MSCT was high density bony foreign body,and the coincidence rate was 5/5.In 43 children,MPR (CPR) showed 41 cases (95.3％),CTVB showed 33 cases (76.7％),MinIP showed 34 cases (79.1％),VR showed 23 cases (53.5％),and axial scan showed 21 cases (48.8％).MPR (CPR) in showing foreign body rate was higher than other several postprocessing methods,and there were statistical differences (P ＜ 0.05).There was no statistical difference in the showing of foreign body between CTVB and MinIP (P ＞ 0.05),but CTVB and MinIP were higher than VR and axial scan,and there were statistical differences (P ＜ 0.05).Conclusions Low dose MSCT three-dimensional reconstruction is satisfactory in the diagnosis of children tracheobronchial foreign body.It can accurately evaluate the exact size,location,shape and pulmonary complications of foreign body,thus it plays an important role in the diagnosis of suspicious tracheobronchial foreign body.

Objective To investigate the techniques,safety,and efficacy of intraoperative holmium laser lithotripsy under cholangioscopic visualization for refractory intrahepatic stones. Methods A total of 38 patients with refractory hepatolithiasis underwent cholangioscopic holmium laser lithotripsy.The laser setting was: the wavelength of 2.1 ?m,the maximum mean output power of 100 W,the pulse peak power of up to 6 kW,and the laser fiber of 400 ?m in diameter.Results The stones were entirely removed on one session in all the 38 patients.The lithotripsy time was 3~5 min,the times of fragmentation was 3~8,and a total of 65 stones were fragmented.No bile duct injuries or biliary leakage happened.Cholangiography and B-ultrasonography at 2 postoperative months found no residual stones.Follow-up for 6 months found no recurrence.Conclusions Application of holmium laser lithotripsy under cholangioscopic visualization for the management of refractory intrahepatic stones is safe and effective.

[Objective] To investigate into the cellular mechanism of growth promotion due to shear stress by studying G1-phase events responsible for the suppression of cell transition from the G1 to S phase of the cell cycle,and to establish the most suitable physiological stress to stimulate bone formation.[Methods]The osteoblasts derived from Kunming murine's calvaria were exposed to Fliud shear stress(FSS:12 dyn/cm2)for 0,0.25,0.5,1,2,4 h,respectively.In the flow chamber,its impact on cell proliferation,differentiation and the effection of cell cycle's G1/S checkpoint were recorded.The cell proliferation was studied by MTT assay.The cell differentiation was assessed through alkaline phosphatase(ALP)activity assay.Flow-cytometry,immunofluorescence and RT-PCR techniques were used to evaluate the proportion of S phase in cell cycle,the activity of CDK2,CDK4 and the expression of E2F-1,p27mRNA,which demonstrate how FSS underlying multiple mechanisms to enhance the cell cycle progression from G1 to S phase.[Results]FSS increased proliferation and advanced the time in cell growth curve,but after 1,2,4 h,the proliferation was inhibited.The FSS also increased the ALP activity,which were significantly stimulated at 0.25 and 0.5 h after shear stress(128% and 158 % of control);but the FSS decreased ALP activity at 1,2,and 4 hs.The proportion of S phase in cell cycle raised within the early period.The S phase rate significantly increased at 0.5 h(P

Objective To investigate the regulatory effect of fluid shear stress(FSS) on the proliferation and differentiation of osteoblasts,as well as the expression of apoptosis-inducing factor,SIVA-1.Methods The third-passage osteoblasts were divided into five experiment groups and one control group.In the experiment groups,1.2 Pa FSS were given to the osteoblasts for 0.25,0.5,1,2,and 4 hours respectively,while the control group received no FSS.Afterwards,the cells were harvested to measure MTT value and ALP activity;mRNA level of SIVA-1 were determined by RT-PCR.Results MTT revealed that the cells proliferation markedly increased in the 0.25 h and 0.5 h experiment groups with advanced cell growth curve;whereas significantly inhibited in 1,2,and 4 h groups.The FSS also increased the ALP activity at 0.25 and 0.5 hour,especially in the 0.5 h group(2.4320?0.205 S unit/100ml,158% of the control;P

Objective To measure the distortion of digital images generated by radiotherapy simula-tor,and to study the appropriate method of correction. Methods The grid correction plate and Microsoft Visual C + + 6.0 were used for correction. The area error and boundary maximum displacement error of dig-ital images before and after correction were calculated. The post-correction images were compared with film images to evaluate the correction method. Results The area error was 0.31% - 12.36%, and the bounda-ry displacement error was more than 0 -6 mm for 4 cm ×4 cm - 12 cm × 12 cm radiation field before correc-tion. For commonly used radiation field(12 cm × 12 cm) ,the post-correction area error and the boundary displacement error were 0.48% and 0.46 mm,respectively. Conclusions The least square and polynomi-al fitting correction method can fulfill the requirement of conventional radiotherapy.

Objective To discuss the treatment method and effect of the application of the dorsal branches island flaps of the digital arteries in clinic.Methods During January,2010 to February,2015,a total of 20 cases of palmar soft tissue defect of the 2nd-5th distal segments of single fingers were incorporated and repaired by the dorsal branches island flaps of the digital arteries in the base of the distal phalanx.The size of the selected flaps was 3.5 cm × 2.5 cm-2.0 cm × 2.0 cm.In addition,palmar soft tissue defect (n =15) of the 2nd-5th middle and distal segments of single fingers were repaired by the dorsal branches island flaps of the digital arteries at the 1/3 site of the proximal digital arteries,and the selected flaps size was 4.5 cm × 2.5 cm-3.0 cm × 2.0 cm.Full-thickness skin graft urethroplasty was used in the donor sites.Flap shape,texture,sensory recovery and texture of the skin region,function recovery of the wounded fingers were followed up at 1,3,and 6 months after operation.Results Thirty-five patients were followed up from 6 to 13 months (average of 7 months).All flaps survived completely in the incorporated 35 cases postoperatively.Flaps had satisfactory appearance,fine texture,and soft texture in the skin transplantation area.The postoperative improvement of sensory function was between S2 and S3,and the two-point discrimination was 10-15 mm.Assessment of the upper limb function using the standard issued by the Hand Surgery Society of Chinese Medical Association graded 23 cases as excellent,10 cases as good,and 2 cases as fair.Conclusion The dorsal branches island flaps of the digital arteries are characterized by easy dissection,reliable blood supply,and no major blood vessels needed to be sacrificed,which is an effective procedure for finger soft issue defect repairing.

BACKGROUND:Bone marrow mesenchymal stem cells(BMSCs)have the properties involving high proliferation capability,widely distribution,functional tissue repair after injury,as well as immune modulation,by which bring us extensive therapeutic possibilities.There are plenty of methods for isolation of BMSCs,yet,BMSCs exhibit discrepancies in varied growth stage and culture conditions.Up to now,there has been no agreement about the identification methods for cultured BMSCs.OBJECTIVE:To review the isolation methods and biological characteristics of BMSCs,and to compare the differential expression of BMSCs between in serum and serum-free medium,prior to and after proliferation,as well as before and after induction.METHODS:A computer-based online search was performed using key words of "bone marrow mesenchymal stem cells,isolation,culture,induce,marker,and characterization" to find documents published in the database of CNKI (http://dlib.cnki.net/kns50/)or Pubmed(http://www.ncbi.nlm.nih.gov/PubMed)from January 2003 to June 2009.The languages were limited Chinese and English.A total of 237 literatures were searched by the computer.RESULTS AND CONCLUSION:The positive rates of CD44 and CD34 of BMSCs isolated by the whole bone marrow culture were smaller than that of the density gradient centrifugation.However,BMSCs isolated by the whole bone marrow culture were superior to those isolated by the density gradient centrifugation in cell viability,proliferation rate,confluence time,as well as generation time.Other methods for BMSCs isolation had drawbacks of large cost and high requirement of experimental equipments.Following conditions were used to identify BMSCs:cell adherence,cell surface molecule labeling,strong self-proliferation ability,as well as potentials multi-directional differentiation.BMSCs exhibit differential expression between in serum and serum-free medium,prior to and after proliferation,as well as before and after induction.

Through a series of chemical reactions, a kind of quaternary ammonium salt derivative of nanodiamond, ND-CO-NH-CH2-CH2-N ( CH3 ) 3+· I-( QAS-ND ) , was obtained , which was confirmed by FTIR, element analysis experiment and the electrochemistry measurements. Mixed myoglobin ( Mb) and QAS-ND solution was dropped on the surface of the glassy carbon ( GC ) electrode to prepare QAS-ND/Mb/GC modified electrode. In 0. 1 mol/L phosphate buffer solution (PBS) (pH 7. 0), Mb in the membrane exhibited direct electrochemical properties and showed good stability. The electrocatalytic property of the modified electrode toward H2 O2 was investigated, the results showed that the modified electrode could be used as the H2O2 biosensor to achieve fast, accurate detection of H2O2, with a detection limit of 3. 5 mmol/L (S/N=3).

Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.