Objective To explore the correlation between adenoid hypertrophy and secretory otitis media.Methods The cases of adenoid hypertrophy were screened and selected by nasopharyngeal lateral X ray.We chose 58 normal children after the clinical examination as control group.In accordance with the degree of adenoid hypertrophy,they were divided into three groups:the normal group,middle-grade and high-grade groups of adenoid hypertrophy with the association between the degree of adenoidal hypertrophy and the incidence rate of secretory otitis media analyzed.Results There was no difference in the incidence rate of secretory otitis media between the normal and middle-grade groups.The incidence rates of secretory otitis media were significantly different between the normal and high-grade groups(P＜0.01).Conclusion The incidence of secvetory otitis media and the degree of adenoid hypertrophy showed positive correlation.The greater is the size of adenoids, the severer is the degree of obstruction of the nasopharyngeal cavity and the higher is the incidence of secretory otitis media.

Objective To compare primary PCI with venous thrombolysis on the clinical effect in patients with AMI. Methods One hundred and thirty two consecutive patients with acute myocardial infarction during thirteen months were divided into primary PCI group( n =75) and venous thrombolysis group(n=57).The reperfusion rate and cardiac events during in hospital and follow up were recorded in two groups. Results The reperfusion rate of venous thrombolysis was 57.9% and 96% in primary PCI group( P

Objective To investigate the clinical effectiveness of dynamic hip screw (DHS) internal fixation and proximal femoral nail (PFN) internal fixation for intertrochanteric femoral fractures.Methods One hundred and sixty-five patients with intertrochanteric femoral fractures were randomly divided into 2 groups,85 patients were in DHS group and 80 patients were in PFN group.The clinical effectiveness,index in operative procedure and complications were compared between two groups.Results The fine rate of DHS group and PFN group was 75.3％(64/85 ) and 83.8％( 67/80 ) (P ＞ 0.05 ).The indexes of function recover time,fracture healing time,amount of bleeding in operation,operation time in PFN group were significant lower than those in DHS group [(54.3 ± 11.7 ) d vs.(92.6 ± 10.5 ) d,(63.8 ± 12.2) d vs.(71.3 ± 10.6) d,(453.3 ± 50.7) ml vs.(627.5 ± 46.8) ml,(77.9 ± 25.2) min vs.( 115.7 ± 32.8) min](P＜0.05 ).The rate of short-term complications was 16.2％ (13/80) in PFN group,and 12.9 ％ ( 11/85 ) in DHS group(P ＞ 0.05 ).The rate of long-term complications was 1.2％( 1/80 ) in PEN group and 4.7％(4/85 ) in plts group (P ＜ 0.05).Conclusions As the treatment of intertrochanteric femoral fractures,PFN internal fixation has less bleeding and better efficacy,and can improve function recovery.PFN internal fixation is a better method for unstable femoral fracture.

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Objective To study the imaging features and adequate interventional therapy of the diffuse type hepatic cellular carcinoma(HCC).Methods Fourteen patients with the diffuse type HCC underwent hepatic angiography and the adequate interventional therapy by TAI or TAE according to imaging appearances,blood supply and function of liver.Results ①Imaging appearances:the most common appearances of fourteen patients with the diffuse type HCC on DSA and CT included:tumor blood vessel was extensive and increased,tumor stain was extensive in left and right liver leaf(such as grain,small spot ,nodule shadows or low density area),liver enlarged obviously with liver cirrhosis,portal vein tumor thrombus,arteriopotal shunt and widespreadly scattered iodized oil,et al.②Therapeutic effect:the mean survival time of fourteen patients was 3 months,the longest survival period was 10 months and the shortest one was olny 15 days.Conclusion ①The specific appearances of the diffuse type HCC are diffuse small spot-like,frosted glass-like,double orbit-like and big liver-like.②The interventional therapeutic effect and prognosis of the diffuse type HCC are the worst than that of other type primary hepatic carcinoma.Selecting adequate interventional therapeutical plan can obviously prolong survival time of the patient.

Laser tweezers Raman spectroscopy ( LTRS ) was used to study the inhibitory effect of indol on staphyloxanthin biosynthesis in Staphylococcus aureus cells and the dynamic changes of this pigment content inside bacterial cells during batch cultivation. The Raman spectra of Staphylococcus aureus cells cultivated for different time and exposed to various doses of indol were acquired. The intensity of 1523 cm-1 band was used for the quantification of staphyloxanthin, in the meantime, the pigment was measured by UV spectrometry. The experimental result showed that an excellent linear relationship existed between the intensities of Raman peak at 1523 cm-1 of bacterial cells and the pigment contents estimated by UV spectrometry, with a correlation coefficient of 0 . 9772 . The spectral data at population level as well as single cell level revealed that indol could inhibit the production of pigment in dose-dependent manner, and the pigment content in bacterial cells incubated with indol decreased by 70%. Under the batch growth condition, the pigment amount in Staphylococcus aureus cells reached the maximum value during the middle exponential growth phase ( 12 h ) and the heterogeneity of pigment content in bacterial cells within certain populations at various time points was relatively small, with RSDs of 39. 2% to 61. 1%. This investigation indicates that LTRS can be served as a reliable method for the analysis of staphyloxanthin content at single cell level.

Objective To investigate the effects of the treatment of open injury and orthopedic postoperative wound infections with Vacuum Sealing Drainage.Methods Retrospective analysis of the clinical results of 32 patients with open injury or orthopedic postoperative wound infections in our hospital.Results Follow the indications and contraindications strictly and ensure right pressure,all the infection of wounds was controlled,and split skin graft survived.Without the package and pressurized fixation,the wounds healed better.Conclusion Vacuum Sealing Drainage can be considered one of the effective methods to treat the open injury or orthopedic postoperative wound infections and is worthy to be carried out as a routine.For patients with vascular rupture or defect,when there was still skin defects after vascular graft repair,as long as covered vascular anastomosis with the surrounding skin and soft tissue during the operation,there was still can use closed vacuum sealing drainage to cover the wound to prevent infection.

ObjectiveTo explore the clinical outcomes of posterior lumbar interbody fusion using BTwin expandable spinal spacer with microendoscopic discectomy (MED) for lumbar disc herniation accompanying degenerative instability.MethodsFrom March 2006 to May 2010,87 patients with lumbar disc heniation (only one level) accompanying degenerative instability were managed with posterior lumbar interbody fusion using B-Twin with MED,includeing 49 males and 38 females with an average of 47.6 years(range,37-65).Objective level located in L3,4 in 2 cases,L4,5 in 43,and L5S1 in 41.The patients were treated with single BTwin(Single group,n=51) and double B-Twin(Double group,n=36).Clinical outcomes were evaluated with surgical time,blood loss,visual analogue scale (VAS) scores,Oswestry disability questionnaire (ODI),and the pre- and post-operative disk space heights.ResultsThe patients were followed up for an average of 35.8months (range,12-46).All the patients felt the low back pain and radiation pain disappeared or relieved apparently.The mean preoperative ODI and VAS scores decreased from 78％±3％ to 18％±3％,and (8.70±11.3)to (0.65±10.48) at the final follow-up respectively.Disc space increased from a pre-operative height of (8.76±1.3) mm to a post-operative of (11.8±0.6) mm.ODI,VAS and the disk space heights in all patient showed statistical significance,which revealed no statistical significance between the two groups.However,the operation time,blood loss were statistical difference between the two groups.All the patients achieved solid union or probable union at a mean time of 5.6 months (range,3.9-8.6).ConclusionPosterior lumbar interbody fusion using B-Twin with MED can obtain satisfactory outcomes in the treatment of lumbar disc herniation accompanying degenerative instability.Single B-Twin can get similar clinical outcomes,but shorter surgical time,less blood loss,and less medical costs.

ing microecological preparation,or continuously pumping EN fluid into the stomach or jejunum may reduce the incidence of diarrhea.

Objective To evaluate the effect of proper nutritional therapy guided by indirect caloimetry . Methods According to the digitaltable ,70 critically ill patients whose APACHE II >5 were randomly divided into oberserving ( nutritional therapy guided by indirect caloimetry ) and control groups ( nutritional therapy guided by harris-benedict formula),each group 35 cases.The results of nutrition support were analysed .Results TP,MAMC,ALB were higher than that before treatment in oberserving group (all P<0.05),the MAMC was also higher than that in control groups(P<0.05).There was no significant difference in Hb and TSF after treatment IN oberserving group (all P>0.05).Conclusion The nutritional therapy guided by indirect caloimetry by harris-benedict formula have the some nutritional effect in critically ill patients .