OBJECTIVE: To study the clinical feature and treatment of extracranial and intracranial complications caused by otitis media. METHOD: Three hundred and twenty patients of acute and chronic otitis media were admitted to our department between 2005 and 2014. Among them, 34 patients were diagnosed with extracranial and intracranial complications. The clinical features and treatment outcome were retrospectively studied. Of the 34 patients associated with complications, 25 had a single complication,8 had two complications and 1 had three complications. Complications included labyrinthitis in 14 cases, facial paralysis in 11, postauricular subperiosteal abscess in 6, Bezold abscess in 1, thrombophlebitis of sigmoid sinus in 2, otitis meningitis in land otogenic brain abscess in 8. RESULT: Thirty-three patients were cured or improved and 1 patient died. CONCLUSION Due to the widespread use of antibiotics, the clinical manifestations of extracranial and intracranial complications of otitis media become more hidden and atypical. The surgery is the primary treatment method.
Brain Abscess ; complications ; Chronic Disease ; Facial Paralysis ; complications ; Humans ; Labyrinth Diseases ; complications ; Mastoiditis ; complications ; Meningitis ; complications ; Otitis Media ; complications ; physiopathology ; Retrospective Studies ; Treatment Outcome

ObjectiveTo understand the clinical and microbiological characteristics of AIDS-associated bloodstream infection (BSI).MethodsThe clinical and laboratory ifndings of 143 cases of BSI in AIDS patients who were hospitalized during the period from 2013 to 2014 were retrospectively analyzed.ResultsThe prevalence of BSI in AIDS patients was 22.1%. The 143 patients were divided into two groups in terms of fungal or bacterial infection. The incidence of speciifc skin rashes, anemia, hepatosplenomegaly and lymph node enlargement in fungal infection group was higher than those in bacterial infection group (allP<0.05). CD4+ cell count, WBC, neutrophils, RBC, hemoglobin, and platelet count in fungal infection group were lower than those in bacterial infection group, while AST and Cr were the opposite (allP<0.05).Penicillium marneffei(84/143, 58.7%) was the most common pathogen isolated from AIDS-associated BSI, followed byEscherichia coli (10/143, 7.0%),Cryptococcus neoformans (9/143, 6.3%),Klebsiella pneumoniae (7/143, 4.9%),Salmonella (6/143, 4.2%),Candida albicans(3/143, 2.1%), andAeromonas (3/143, 2.1%). Most strains were still susceptible to the commonly used antibiotics.ConclusionsThe prevalence of BSI is high in AIDS patients. Fungal BSI is more likely to have skin rash, anemia, hepatosplenomegaly and lymphadenopathy, hematologic abnormalities, liver and renal function impairment. Fungi, especiallyPenicillium marneffei, are the main pathogen of AIDS-associated BSI. Most strains are susceptible to the commonly used antibiotics.

Objective To determine the relationship between cigarette smoking and the incidence of systemic lupus erythematosus.Methods Database including Cochrane Library,Pubmed,OVID and Elsevier were electronically searched to collect case-control and cohort studies on the relationship between cigarette smoking and incidence of systemic lupus erythematosus.The literatures were screened and the data were extracted independently according to the inclusion and exclusion criteria.The quantitative analysis were performed by using Stata 12.0 software.Results The pooled OR values (95％ confidence interval)of current smoking and ever smoking were 1.82 (95％CI 1.42～2.34) and 1.22 (95％CI 0.96～1.56) respectively.Conclusions Our Meta-analysis revealed a moderate but statistically significant association between current smoking and development of systemic lupus erythematosus.However,it is still not confirmed whether the past smoking is one of the risk factors of systemic lupus erythematosus.

Objective To investigate the influence of telephone follow-ups on the compliance of syphilis patients.Methods The 120 patients diagnosed with syphilis during February 2010 to December 2011 were randomly divided into experiment group and control group with 60 cases in each group.The control group was given disease-related education during outpatient visits,while the experimental group received nursing intervention by phone calls.The two groups were compared in respect of curative compliance. Result The curative compliance of the experiment group after follow-ups was significantly better than that of the control group (P<0.01).Conclusion The telephone follow-ups can significantly improve the curative compliance of syphilis patients,which can significantly prevent the spread of syphilis.

Objective To explore the risk factors for patients with massive hemoptysis in tuberculosis and to provide a strategy for clinical treatment for tuberculosis massive hemoptysis (TMH). Methods Chi-square test and multivariate logistics analysis were applied to analyze the medical data of 241 cases of TMH. Results Chi-squared test showed that eleven factors were found to be significantly correlated with TMH. Longer disease course (≥3 months), lung lesions range ≥ 3 lung fields, pulmonary tuberculosis cavity, a higher smoking index (≥400 cigarettes per year) and clinical treatment were risk factors for TMH. Patients aged 45 years or older accompanied with bronchiectasia, pulmonary fungal infection, diabetes or hepatopathy had higher probabilities of developing massive hemoptysis. Multivariate analysis showed lung lesions range over 3 lung fields (OR = 2.447,P = 0.015), pulmonary tuberculosis cavity (OR = 2.486, P = 0.004), bronchial asthma (OR =3.192,P = 0.002), pulmonary fungal infection (OR = 3.896, P = 0.005) and hepatopathy (OR = 3.101, P =0.006) were final risk factors for TMH. Conclusion Multiple factors contributed to patients with massive hemoptysis in tuberculosis. Lung lesions range over 3 lung fields, pulmonary tuberculous cavities, bronchial asthma, lung fungal infection and hepatopathy might be the independent risk factors for TMH.

Objective The study aimed to evaluate the effects of web-problem-based learning (WPBL) in the application of Fundamental Nursing.Methods The sample was purposively selected.172 students in School of Nursing in Tianjin were recruited as the control group (n=83) and the intervention group (n=89).Traditional teaching method and WPBL was implemented in the control group and the intervention group,respectively.The teaching effectiveness of the two groups was measured by the examination and learning initiative evaluation scale and the teaching effect evaluation questionnaire,and the teaching satisfaction questionnaire was implemented among the intervention group.SPSS 18.0 was used and t test was performed to analyze the comparison between groups.Results In the theoretical examination,the scores of comprehensive analysis of the nursing students in the intervention group were better than those in the control group,and the difference was statistically significant (P＜0.05).In the evaluation of active learning after school,the scores of control learning in the intervention group were higher than those in the control group,and the difference was statistically significant ([14.78 ± 2.16),vs.(13.58 ± 2.16),t=-3.58,P=0.000].83 effective questionnaires of intervention group nursing students' teaching satisfaction were recovered.73 of them (88％) thought that WPBL could improve the students' ability of independent learning,71 students (85.5％) found that WPBL could enhance the ability of information processing,73 students (88％) thought they could communicate well with their classmates in WPBL and cooperate well to complete the task.Conclusion WPBL which is on the basis of PBL and make full use of the network,could promote the ability of autonomous learning,information processing and communication with classmates and good cooperation,but in the application process,it needs teachers to organize reasonably,perfect the supervision mechanism,and reduce taking up students' spare time.

Objective:To construct lentiviral vector which can overexpression miR-137 and produce lentivirus by lentivirus packaging system, and to explore its infection efficiency and expression in HEK293T cells.Methods: miR-137 sequence was chemically synthesized and cloned into lentiviral vector GV209, and the recombinant plasmid containing human miR-137 was obtained and identified.Then miR-137 recombinant plasmid together with two helper plasmids were transfected into HEK293T cells using Lipofectamine 2000.After the HEK293T cells were infected in multiplicity of infection(MOI) 40 for 48 h, the expression of green fluorescent protein (GFP) was observed by fluorescence microscope and the expression level of miR-137 was detected by fluorescence quantitative PCR.Results:The sequencing results showed that the inserted gene sequence was completely consistent with the published human miR-137 gene sequence in GenBank.The GFP was observed in the HEK293T cells infected with miR-137 overexpression lentivirus under fluorescence microscope.The fluorescence quantitative PCR results showed that the expression level of miR-137 in the cells infected with overexpression lentivirus was 12.74 times higher than that in the control cells.Conclusion:The lentivirus containing miR-137 gene is successful packaged, and it could efficiently infect the HEK293T cells.

Objective: To construct the recombinant lentiviral vector containing cardiac adriamycin responsive protein (CARP) gene and small-hairpin RNA (shRNA) targeting CARP gene and to pack the lentivirus, and to lay the foundation for further study on the function and mechanism of CARP in adriamycin (ADR) induced cardiomyopathy. Methods: After the rat CARP gene was amplified by PCR and shRNAs targeting CARP were designed and synthesized, they were inserted into the shuttle plasmids GV-358 or GV-248. respectively. After confirmed by sequencing, the recombinant shuttle vectors containing CARP gene or shRNA and auxiliary packaging plasmid Helper 1 0 and Helper 2 0 were co transfected into the IIEK293T cells for virus packaging and amplification; the viral titer was detected by end point dilution. The IIEK293T cells were infected with the recombinant lentiviruses. and the green fluoresence intensity was observed by fluorescence mircroscope. The H9C2 cells were infected with the recombinant lentivirues and divided into control group. CARP overexpression group and shRNA group; Western blotting method was used to detect the CARP expression levels in the cells in various groups. Results: The DNA sequencing results showed that the sequences of CARP overexpression and shRNA vectors were in accordance with the designed sequences. The expression of green fluorescence protein was seen under fluorescence microscope after transfection of the vectors of the IIEK293T cells. After infection of the H9C2 cells, the expression level of CARP protein in CARP overexpression group was 5. 3 times higher than that in control group ( P=0. 01); while it was down-regulated by 53% in CARP shRNA group compared with control group ( P= 0 02). Conclusion: The lentivirus expression vectors carrying CARP or shRNA targeting CARP are successfully constructed and the lentiviruses obtained could significantly interfere the expression of CARP in the II9C2 cells.

Objective To investigate the application of preoperative autologous blood donation (PABD) in selective operation.Methods Retrospective investigations and analysis were carried out in clinical datas of 1 026 patients of PABD in selective operation from January 2016 to may 2017,comparing with those who had not performed PABD in the same time.Results ①The surgeries of PABD were mainly neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery,respectively,which accounted for 5.97％,4.90％,3.78％,3.76％ and 3.55％ of the patients in the same period;②The rate of transfusion of allogeneic red blood cells of selective operation in PABD group of neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery were 5.66％,2.51％,4.89％,0 and 4.88％,respetively,while not performed PABD group were 25.46％,28.58％,24.77％,10.62％ and 17.54％,respetively;③The rate of transfusion of the group of hemoglobin (Hb)＜ 120 g/L is significantly higher than those Hb is (120-129.9) g/L,(130-139.9)g/L and ≥ 140 g/L(7.65％vs 2.44％,3.66％ and 2.70％,P＞0.05).Conclusion ①PABD is mainly carried out in neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery;②The group of Hb＜ 120 g/L has a high rate transfusion of allogeneic erythrocyte in selective operations;③Only the PABD is improved can patients make benefit from it.

Purpose To explore the immunohistochemical features of neuroendocrine markers, CKpan and TTF-1 and their relationship to TNM stage and prognosis in small cell lung cancer (SCLC). Methods The expression of NSE, CgA, Syn, CD56, TTF-1 and CK-pan in SCLC tissue specimens were detected using immunohistochemical EnVision indirect method. Clinical data and TNM stage of 90 patients were collected and the overall survival ( OS) was followed up by telephone. Results Of 90 cases of SCLC, the vast majority were occured in the elderly men. The ratio of man to woman was 5 to 1. The median age was 64 years old. The stageⅠ+Ⅱ was 21 cases, 30 in stageⅢand 39 cases in stage IV. The positive rate of immunohistochemical staining of neuroendocrine markers for NSE, CgA, Syn and CD56 were 83. 3%, 70%, 65. 5% and 86%, respectively. The positive rate of CKpan, TTF-1 were 92. 2% and 81. 1%. Kaplan-Meier analysis indicated that the expression of TTF-1 and NSE were significantly correlated with the TNM stage and over-all survival of patients with SCLC (P<0. 05). The median OS was 8 months in positive expression of TTF-1, which was higher than those in negative expression of TTF1 (5. 5 months)(P=0. 000). The median OS was 7 months in NSE positive expression which was lower than those in negative expression of NSE (11 months)(P=0. 009). The median OS of stageⅠ+Ⅱ,ⅢandⅣwere 16 months, 9 months and 4 months with significant difference ( P=0. 000 ) . Cox multivariate analysis indicated the TTF-1 expression and TNM were independent prognostic factors for the OS of the SCLC patients. Conclusion Most of SCLC has neuroendocrine differentiation, expression CKpan and TTF-1. The expression of TTF-1 may be negative correlation but NSE positive correlation with the prognosis of SCLC patients. And the TTF-1 expression and TNM may be independent prognostic factors for the OS of the SCLC patients.