Objective To evaluate the clinical application value of Xpert detection system of Clostridium difficile (C.difficile).Methods A total of 43 stool specimens from the patients with diarrhea were collected,and C.difficile in stool specimens were detected by the Xpert detection system,the toxigenic culture method,and the toxin detection method which detected the toxin of C.difficile by VⅥDAS automatic analyzer after anaerobic culture,respectively.The analytic performance of Xpert detection system was evaluted based on the toxigenic culture method as the gold standard.Meanwhile,the consistency of the results from different detection methods was compared.The ribotype 027 strain (ATCC BAA-1870) simulating the stool specimen was further used to verify the Xpert detection system.Results Based on the gold standard of the toxigenic culture method,the sensitivity,specificity,positive predictive value and negative predictive value of the Xpert detection system were 90.9％,93.8％,83.3％ and 96.8％,respectively.The Kappa values for the consistency between the Xpert detection system and the toxigenic culture method or the toxin detection method were 0.822 (P ＜ 0.05) and 0.419 (P ＜ 0.05),respectively.Moreover,the ribotype 027 strain simulating the stool specimen was verified by the Xpert detection system successfully.Conclusion The Xpert detection system may rapidly and accurately detect the C.difficile in stool specimens,especially the ribotype 027 strain with high toxicity.

OBJECTIVE: This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation. METHOD: We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered. RESULT: The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75. CONCLUSION Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.
Adolescent ; Adult ; Aged ; Auditory Perception ; Cochlear Implantation ; psychology ; Follow-Up Studies ; Humans ; Middle Aged ; Retrospective Studies ; Self Concept ; Social Identification ; Treatment Outcome ; Young Adult

Polydopamine (PDA) nanoparticles were prepared as a carrier, and bavachinin (BVA) was efficiently loaded by physical adsorption.The erythrocyte membrane was further utilized to modify and construct the erythrocyte membrane biomimetic nanoparticles (RBC-BP), the residence time in the body was extended and the in vivo analytical method was established to investigate their pharmacokinetics in mice.Polydopamine nanoparticles loaded with BVA (BP) were prepared by solvent replacement method, and the influencing factors of PDA loaded with BVA were investigated with the adsorption rate as the evaluation index.The erythrocyte membrane was extracted and separated, and RBC-BP was prepared by incubation coextrusion method. The effects of pH value on membrane coating and the extrusion times on the particle size and uniformity of RBC-BP were investigated.The particle size, potential, morphology, and cumulative release rate of RBC-BP were systematically characterized, and their pharmacokinetics in mice were preliminarily explored.The results showed that the adsorption rate of BP was as high as (92.08 ± 0.17) % and the drug loading rate was (42.05 ± 2.95) % at the PDA to BVA ratio of 1∶0.5, the solution pH value of 7, the incubation time of 6 h, and the incubation temperature of 20 °C, and that the erythrocyte membrane could be successfully oriented and coated on the surface of BP by the action of electric charge at the pH value of 4. The in vitro studies showed that RBC-BP has the apparent core-shell structure with the particle size of (308.63 ± 6.56) nm and good stability, and in vivo pharmacokinetic studies showed that RBC-BP can significantly extend the circulation time of nanoparticles in vivo.

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was <0 .05 .There was no statistical significance among group comparisons for other factors as the P was >0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

OBJECTIVE: To detect the expression of AQP5, HIF-1alpha and VEGF in human nasal polyps, and to observe the relationship of AQP5 with HIF-1a and VEGF, and to investigate their role in the pathogenesis of nasal polyps. METHOD: Using the techniques of Real-time Quantitative Polymerase chain Reaction and Western blot, the expressions of AQP5, HIF-1alpha, VEGF mRNA and protein were examined. The specimens were obtained from patients underwent endoscopic surgery at the same time, including eighteen nasal polyps and ten inferior turbinate tissues. RESULT: (1) The result of RT-PCR showed that the expressions of the AQP5 mRNA were lower in nasal polyps than those in inferior turbinate tissue (P < 0.01); there was no significant difference between the expression of HIF-1alpha mRNA or VEGF mRNA in nasal polyps and inferior turbinate tissues (P > 0.05); (2) According to the Western blot, there was no significant difference between the expression of AQP5 in nasal polyps and inferior turbinate tissues (P > 0.05); the expression of HIF-la or VEGF were higher in nasal polyps than those in inferior turbinate tissues (P < 0.05); (3) According to the Western blot, there was a positive correlation between the expression of AQP5 and that of HIF-1alpha (r = 0.633, P < 0.05), and the correlation was also existed between AQP5 and that of VEGF (r = 0.611, P < 0.05). CONCLUSION AQP5, HIF-1alpha, VEGF are all involved in the edema formation of nasal polyps. The changes of AQP5's distribution can cause accumulation of water in nasal polyps, HIF-1alpha, VEGF can induce new blood vessels and increase vasopermeability in nasal polyps; they have separate regulatory mechanism in edema formation, but might have some relationships in some ways.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aquaporin 5 ; metabolism ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Nasal Polyps ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

OBJECTIVE: To investigate the clinical feature, diagnosis and endoscopic surgery of choanal polyps (CP) from posterior ethmoid sinus. METHOD: Eleven cases with CP from posterior ethmoid sinus treated by endoscopic endonasal surgery between January 2002 to June 2007 were retrospectively reviewed. Clinical manifestation, intranasal and intrasinus lesions, methods and attentions of endoscopic surgery and therapeutic effects were analysed. RESULT: All cases were treated by endoscopic surgery and CP were found originated from posterior ethmoidal ostium. Lesions in posterior ethmoid sinus included 3 (27.3%) cyst, 5 (45.4%) polyp and 3 (27.3%) mucosal edema. No operation complications were observed. The follow-up period ranged from 6 months to 3 years (mean 1.2 years) and no recurrence was founded. CONCLUSION Most of CP originated from posterior ethmoidal ostium and its formation might be related to the cyst in the sinus. Endoscopic surgery represents a minimally invasive and highly successful procedure, complete removal of CP and lesions in the sinus can reduce the recurrence.
Adult ; Endoscopy ; Ethmoid Sinus ; pathology ; Female ; Humans ; Male ; Nasal Polyps ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVE: To confirm the expression and distribution of aquaporin 5 (AQP5) in nasal polyps. METHOD: AQP5 were studied in 20 samples nasal polyp without AR (Group NAR) and 16 samples with AR (Group AR) with immunochemistric staging and its integrated light intensity and its grey step. RESULT: (1) Hematoxylin and eosin staining showed that there was obvious inflammation reaction, a large quantity of glands hyperplasia and acidophils soaked in nasal polyps, especially those with allergic rhinitis. (2) Immunofluorescence technique showed that the distribution of AQP5 in the two groups was in accordance with that in nasal polyps on the whole. AQP5 expressed mainly in the membrane and cytoplasm of the epithelium of the glands, ducts and cilia. (3) The statistical analysis of the immunohistochemical staining showed that the integrated light intensity of AQP5 in Group AR (0.1675+/-0.006536) was obviously higher than that in the Group NARs nasal polyps (0.09343+/-0.001816). There was statistical significance between the two groups (t = -12.00, P<0.01). (4) The statistical analysis of the immunohistochemical staining showed that the grey step of AQP5 in Group AR (175.6+/-2.471) was obviously lower than that in the Group NAR's nasal polyps (206.2+/-0.9649). There was statistical significance between the two groups (t=12.46, P<0.01). CONCLUSION AQP5 is expressed in nasal polyp. Combined with the research before, it was conferred that the hypersecretion of glands and its character has a relationship with the high expression of AQP5 in nasal polyps, and nasal polyp with different symptom has different mechanism.
Adolescent ; Adult ; Aged ; Aquaporin 5 ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; metabolism ; Nasal Polyps ; complications ; metabolism ; Rhinitis, Allergic, Perennial ; complications ; metabolism ; Young Adult

OBJECTIVE: To explore the characteristic of formant-a very important parameter in the spectrogram of three types of artistic voice (western mode; Chinese mode; Beijing opera). METHOD: We used MATLAB software to make the short-time Fourier transform and spectrogram analysis on the homeostasis vowel examples of the three types. RESULT: The western mode had different representation "singer formant" (Fs) based on the voice part; the Chinese mode's notable features were that F1, F2, F3, were continuous and the energy of them changed softly; the Beijing opera had the common representation which was a very wide formant and there was soft transition between formants and various harmonic, besides it showed a similar component like the "Fs" (two formants connected normally). CONCLUSION Different artistic voice showed their own characteristics of the formant parameter in the spectrogram, which had important value on the identification, objective evaluation and prediction.
Adult ; Female ; Humans ; Male ; Middle Aged ; Music ; Spectroscopy, Fourier Transform Infrared ; Voice Quality ; Young Adult

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.

OBJECTIVE: To diagnose the mycotic otitis media correctly and to explore the most adequate treatment for the disease. METHOD: Thirty-six inpatients (39 ears) with mycotic otitis media in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2007 were analyzed retrospectively. Morphous of the fungi, the methods and efficacies of the treatment were analyzed respectively. RESULT: According to the fungal cultures, 27 ears were induced by mold fungus and 12 ears were induced by budding fungus. Among these 36 patients (39 ears), myringoplasty accompanied local antifungal cream were applied in one ear, mastoidectomy with canal wall down and/or tympanoplasty accompanied with oral antifungal medication were administrated in 35 ears, only oral antifungal drugs were used in 3 ears (the control ears of the bilateral mycotic otitis media, which was not treated by surgery). All of the patients were followed up for 3 to 36 months, otorrhea occurred in the patients who refused to oral antifungal medication for 3 weeks after the myringoplasty, then dry again by local antifungal cream, but otorrhea recurred 3 times within 2 years. Thirty-five patients (38 ears) acquired dry ear after surgery and/or oral antifungal drugs, but 2 of the 38 ears recurred separately at the fourth and sixth month after their surgeries, then dry again by irrigation with hydrogen peroxide and by administrating local antifungal cream for 3 weeks. CONCLUSION Otologists should elevate suspicion of mycotic otitis media when they meet patients with continuous otorrhea and patients who did not respond to the antibacterial treatment. The diagnosis based on microbiological findings, such as direct microscopy or fungal cultures should be done as soon as possible. If the otomycosis is decided, we suggest that topical treatment should be selected firstly, although most patients in present study were treated by surgery accompanied with oral antifungal medications. If there is obvious bone erosion, surgery is necessary to excise the pathological tissues, minificate the mastoid cavity and close the middle cavity in order to improve the hearing and prevent the infection from the outer ear.
Adult ; Aged ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Mycoses ; diagnosis ; therapy ; Otitis Media ; diagnosis ; microbiology ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult