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

BACKGROUND: Posttraumatic stress disorder(PTSD) arises as a delayed and /or protracted response to a stressful event or situation of an exceptionally threatening or catastrophic nature. There have been reports about natural disasters causing PTSD, but there have been few reports about PTSDcaused by technological disasters. Our study investigated the mental status of those survivors after a serious explosion.OBJECTIVE: To investigate the characteristics and the factors of impact of PTSD caused by technological disasters.DESIGN: A case controlled study of the survivors of a momentous explosion.SETTING: A provincial mental health center.PARTICIPANTS: A serious explosion happened in Urumqi on September 8, 2000. Twenty-eight survivors(as the study group) who were still hospitalized for treatment 3 -5 months after the accident were involved in this study. And in the control group were 30 normal persons whose general demographic data were the same as those patients.METHODS: A psychiatrist told the subjects the following: The objective and meaning of the test, and explained the self-making questionnaire about their general condition, symptom checklist (SCL-90), self-rating anxiety scale (SAS), self-rating depression scale(SDS), cornell medical index(CMI), the questionnaire on dealing styles, the questionnaire on social support, and others-evaluating scale, incident effect scale(IES); a list of stress reaction symptoms.MAIN OUTCOME MEASURES:Main resulta:①Clinical feature of PTSD caused by the technological disaster.②the related factors to PTSD in the technologal disaster.Secondary results: Comparison of the results between the two groups in IES, CMI, SDS and SAS.RESULTS: A total of 22(79% ) survivors met the criteria as PTSD. There were significant differences in all the assessments(IES, CMI, SDS, SAS,SCL-90) between the study group and the control group (t =3.62-8.17, P ＜ 0.01 ) . The diagnosis of PTSD was positively correlated with the level of traumatic exposure( r = 0. 420, P ＜ 0. 05), and negatively correlated with the degree of satisfaction with the post-event solutions( r = 0. 420, P＜ 0.05), positively correlated with IES scoring and the level of heart pain ( r = 0. 389 - 0. 665, P ＜ 0. 01 ) . The total scores of IES were positively correlated with the level of exposure ( r = 0. 478, P ＜ 0.05 ).CONCLUSION: The incidence of PTSD after explosion was high, and its occurrence was related with the degree of exposure in the event and that of the satisfaction with the post-event solutions.

Objective To study role of MDC/CCI22-CCR4 axis in mouse milky spots with peritoneal carcinomatosis of gastric cancer. Methods We examined the expression of CCR4 in 615 Mouse gastric cancer cell (MFC) lines by RT-PCR and Western-blot; Peritoneal metastasis model on the 615mouse was established by intraperitoneal injection of 0.2 ml MFC cells(1×104 cells). Dil fluorescence was used to observe the transfer process and section of MFC. Immunohistochemistry was conducted to detect the expression of CCR4 and CCL22 in omental milky spot; the structure of Milky spot was observed by scanning electron microscopy. Mice were randomly divided into 2 groups, namely, the saline control group (received saline) and MFC group. The concentration of CCL22 in ascitic fluid was measured in the 615 mice injected MFC after 6,8,10 days and in the saline group. Results MFC first metastasizes to the milky spot on the omentum, the expression of CCR4 and CCL22 were observered in the milky spot. The surface layer cells in milky spot consisted of discontinuous mesothelial cells and mainly macrophages and lymphocytes. The average value of CCL22 was 43 pg/ml and 364 pg/ml respectively in saline control group and MFC group.Conclusions MDC/CCL22-CCR4 axis plays an important role in the development of peritoneal carcinomatosis in mouse gastric cancer.

PURPOSETo explore the possible surgical factors related with nonunion in femoral shaft fracture following intramedullary nailing.

METHODSWe retrospectively analyzed totally 425 patients with femoral shaft fracture in level I urban trauma center, including 254 males and 171 females, with an average age of 37.6 (ranging from 21 to 56) years old. The inclusion criteria included: (1) traumatically closed fracture of femoral shaft, with pre- operative films showing non-comminuted fracture, such as transverse fracture, oblique fracture or spiral fracture; (2) closed reduction and fixation with interlocking intramedullary nail at 3-7 days after trauma; (3) complete follow-up data available. The relationship between the following factors (fracture site, reduction degree, direction of nail insertion and nail size) and nonunion was studied.

RESULTSThe incidence of femoral nonunion was 2.8% in patients with closed simple fracture undergoing interlocking intrameduallary nailing, including 11 cases of hypertrophic nonunion. Nonunion was related significantly to distal fracture, unsatisfactory reduction and unreamed nail (p < 0.05). There was no significant difference between antegrade nail and retrograde nail (p > 0.05).

CONCLUSIONSNonunion in femoral shaft facture following interlocking intramedullary nailing is related to fracture site, fracture reduction and nail diameter. The choice of reamed nails or unreamed nails depends on the fracture site and reduction degree.

Adult ; Age Distribution ; China ; Cohort Studies ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Fracture Healing ; physiology ; Fractures, Ununited ; epidemiology ; etiology ; surgery ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Reoperation ; methods ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Time Factors ; Trauma Centers ; Treatment Outcome ; Urban Population ; Young Adult

OBJECTIVEIn the recent twenty years, the diaphragmatic contraction, relaxation functions and electric activity have been explored through electromyography (EMG) and transdiaphragmatic pressure (Pdi) determination. But these techniques required some complex and expensive instruments, so the diagnosis and treatment of children's diaphragmatic fatigue have not been well evaluated. The present study explored the diagnosis of children's diaphragmatic fatigue through measuring ribcage-abdomen motion and analyzed its asynchrony.

METHODSFifty-three children (male 37, female 16, and age rage from 1 months to 9 years) with respiratory rate > 30 breaths/min, heart rate > 110 beats/min, and respiratory dysfunction had asynchronized ribcage-abdomen motion showed by impedance respirograph (IRG). The authors observed whether ribcage-abdomen motion was synchronic and calculated M levels (staggered peak time/total duration of the breathing cycle). The ribcage and abdomen outputs were displayed on vertical (for rib cage) and horizontal (for abdomen) axes of X-Y instrument. In addition, the change of respiratory frequency and heart rate was observed and arterial blood-gas analysis was also performed.

RESULTS(1) M levels in one-dimensional IRG were positively correlated with alpha angle in two-dimensional IRG (r = 0.956, P < 0.001). Asynchronized respiratory motions could be divided into three types. type I showed completely contra-directional movements of respiration, M levels for (48.1 +/- 4.4)%, an irregularly clockwise loop in the two dimensional IRG, and alpha angle for (138.3 +/- 15.0) degrees. In type II, one dimensional IRG showed displaced peak of the chest and abdomen motion curves, M levels were (16.5 +/- 4.7)%, two dimensional IRG was displaced in a counterclockwise direction, and alpha angle was (55.3 +/- 10.8) degrees. In type III, abdominal motion curve of one dimensional IRG had double peaks, M levels were 0, two dimensional IRG was presented as 8-shaped double circles, alpha angle was (41.3 +/- 3.8) degrees; (2) pH levels in the patients with type I and type II diaphragmatic fatigue were significantly lower, and PCO(2) levels were significantly higher than those with type III or in the normal subjects (P < 0.001 for all), but there was no statistically significant difference between type III and the normal subjects (P > 0.05); (3) Both of respiratory rate and heart rate in type I, type II and type III were higher than those in the normal subjects (all P < 0.001), and the differences among the three types were significant (P < 0.001 for all); (4) Both M levels and alpha angle were negatively correlated with pH levels (r = -0.514, P < 0.001 and r = -0.497, P < 0.001), while positively correlated with PCO(2) levels (r = 0.672, P < 0.001 and r = 0.625, P = 0.01).

CONCLUSIONS(1) IRG can be reliably used to diagnose children's diaphragmatic fatigue. This technique is simple and easy to perform and non-invasive. It is therefore worthy of recommending for further clinical investigations. (2) According to the characteristics of IRG, diaphragmatic fatigue can be divided into three types. (3) The development of children's diaphragmatic fatigue has a series of characteristic changes. (4) To avoid the patients suffering from respiratory failure, it is the key time to adopt the policies of prevention and treatment when IRG shows signs of type III diaphragmatic fatigue.

Child ; Child, Preschool ; Diaphragm ; physiopathology ; Fatigue ; classification ; diagnosis ; Female ; Humans ; Infant ; Male ; Respiration ; Respiratory Function Tests ; methods

A total of 33 patients with isolated lilac artery aneurysms, 19 males and 14 females, who received treatment between January 1997 and June 2007, were retrospectively analyzed. Among these patients, 29 suffered from unilateral iliac artery aneurysm and 4 from bilateral iliac artery aneurysm. Under general anesthesia, all patients were subjected to aneurysmectomy, followed by vascular prosthesis implantation for vascular reconstruction. Results revealed that among 4 cases of bilateral iliac artery aneurysm, there was 1 case who was subjected to aorta-bilateral femoral artery vascular prosthesis implantation, and there were 3 cases who underwent aorta-bilateral lilac artery vascular prosthesis implantation; among 29 cases of unilateral lilac artery aneurysm, there was 1 case receiving aorta-common lilac artery vascular prosthesis implantation, 3 cases undergoing iliac-femoral artery vascular prosthesis implantation, 21 cases subjected to common-external iliac artery vascular prosthesis implantation, and 4 cases undertaking common -common lilac artery bypass. Color Doppler ultrasonic examination, spiral CT angiography, or digital subtraction arteriography was performed 3, 6 months, 1, 3, 5, 8, and 10 years after surgery. The mean follow-up time was 5 years. Three cases died of acute cerebral infarction, myocardial infarction, and traffic accident 3, 6, and 2 years after surgery, respectively. The remaining cases well survived as determined by no recurred Uiac artery aneurysm, anastomotic stoma stenosis or lower limb ischemia found. These results indicated that aneurysmectomy and subsequent vascular prosthesis implantation remained a good and primary means for treatment of isolated iliac artery aneurysm under the present medical condition.

OBJECTIVE:To explore the effects of the different compatibility ratios of rutin with quercetin on the pharmacoki-netics of rutin in rats in vivo. METHODS:30 rats were randomly divided into rutin group(rutin-quercetin molar ratio of 4:0,the same below),quercetin group(rutin-quercetin ratio of 0:4),BL1 group(rutin-quercetin ratio of 3:1),BL2 group(rutin-quercetin ratio of 2:2)and BL3 group(rutin-quercetin ratio of 1:3),6 rats in each group,all group was administrated 10 mg/kg(calculat-ed by quercetin core of rutin and quercetin) intragastrically. The blood sample 0.3 mL was respectively taken from tail vein after 0.25,0.5,0.75,1,1.5,2,3,4,6,8,10,12,16,20,24 h of administration,the plasma concentration of quercetin(rutin me-tabolite) was determined by HPLC. DAS 2.0 software was used to calculate the pharmacokinetic parameters. RESULTS:The AUC0-24 h in rutin group,quercetin group,BL1 group,BL2 group and BL3 group were (4.908 ± 0.877),(8.382 ± 3.671), (8.473 ± 0.709),(4.366 ± 2.297),(8.914 ± 2.642)μg·h/L;MRT0-24 h were (9.675 ± 1.359),(3.142 ± 0.489),(3.517 ± 1.128), (3.376 ± 1.046),(4.494 ± 1.653) h;tmax were (5.726 ± 5.645),(1.375 ± 0.703),(1.125 ± 1.438),(1.417 ± 2.300),(1.292 ± 0.954) h;and cmax were (0.609 ± 0.202),(2.341 ± 0.539),(2.425 ± 1.217),(1.464 ± 0.677),(3.325 ± 2.425)μg/L. Compared with rutin group,AUC0-24 h and cmax in quercetin group,BL1 group and BL3 group were significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05);cmax in BL2 group was significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05). Compared with quercetin group,except AUC0-24 h was significantly decreased in BL2 group(P<0.05),there were no significant differences in AUC0-24 h,MRT0-24 h,tmax or cmax in BL1 group,BL2 group and BL3 group(P>0.05). CONCLUSIONS:Quercetin can inhance the related indexes of rutin in rats in vivo.

Objective To investigate the effect of cannabinoid receptor 1 ( CBR1 ) on spatial learning and memory function of neuropathic pain ( NP ) model rats and the expression of N-methyl-D-aspartic acid receptor 1(NR1) subunit in medial prefrontal cortex (mPFC).Methods Thirty-six healthy male Wistar rats were randomly divided into 4 groups, with 9 rats in each group: the sham operated group (SO group), the neuropathic pain model group (NP group), the NP model group with an mPFC injection of saline ( NS group ) , and the NP model group with an mPFC injection of the CBR 1 antagonist AM251 ( AM251 group).The NP model was prepared using the operation of chronic constriction injury ( CCI) of the right sciatic nerve.The mechanical withdrawal threshold ( MWT ) and the thermal withdrawal latency (TWL) of the rats in each group were detected at 3, 7, 14, 21 and 28 days after the operation.At 29 days after the operation , 18 rats of NP model were randomly selected and given an mPFC injection of saline or AM251 using a three-dimensional brain puncture.At days 30-37 after operation , the eight-arm maze test was performed to detect the spatial learning and memory function of the rats , and the rats were sacrificed immediately after this test.The expression levels of CBR1, NR1 and phosphorylated-N-methyl-D-aspartic acid receptor 1 ( p-NR1 ) ( Ser896 ) in the mPFC brain region were detected by Western blotting , RT-PCR and immunofluorescence.Results Compared with the SO group , the pain thresholds and the spatial learning and memory function of the rats in the NP group were significantly lower ( both P <0.05 ).Compared with the NS group , the rats in the AM251 group showed improvement about spatial learning and memory function ( P<0.05).Compared with the SO group ( the mRNA and protein level of CBR 1:0.23 ± 0.06,0.42 ±0.03), the mRNA(0.43 ±0.12) and protein (0.53 ±0.05) level of CBR1 in NP group increased (both P<0.05).Compared with the NS group (the mRNA and protein level of CBR1:0.42 ± 0.11,0.52 ±0.10), the mRNA (0.53 ±0.05) and protein (0.98 ±0.17) level of CBR1 in AM251 group increased (both P<0.05).Compared with the SO group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.50 ±0.15,0.65 ±0.05,0.79 ±0.15), the mRNA (0.94 ±0.07) and protein (0.24 ±0.05) level of NR1 in NP group decreased (both P<0.05), the protein level of p-NR1 (0.33 ± 0.04) decreased (P<0.05).Compared with the NS group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.09 ±0.14,0.26 ±0.06,0.31 ±0.08), the mRNA(1.58 ±0.10) and protein (1.42 ±0.10) level of NR1 in AM251 group increased (both P<0.05), the protein (0.95 ±0.15) level of p-NR1 increased ( P<0.05).Conclusion CBR1 can decrease the expression level of NR 1 and p-NR1 in the mPFC brain region of NP model rats and induce the spatial learning and memory impairment.

Objective:To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique.To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth.Methods:In the study,180 periodontally healthy Chinese youth (75 males,and 105 females )aged 20 -30 (24.3 ±4.5)years were included.With the standardized upper central incisor photography technique,pictures of 360 upper central incisors were ob-tained.Each tooth was classified as triangular,ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity.The standardized digital photo was also used to evaluate the gingival papilla filling situation.The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed.Statistical analyses were performed with SPSS 19.0.Results:The proportions of triangle,ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113 /360),37.2% (134 /360)and 31.4% (113 /360 ), respectively ,and no statistical difference was found between the males and females.Average κvalue be-tween each two evaluators was 0.381.Average κvalue was raised up to 0.563 when compared with the final classification result.In the study,24 upper central incisors without contact were excluded,and the papilla filling rates of triangle,ovoid and square crown were 56.4% (62 /110),69.6% (87 /125 ), 76.2% (77 /101)separately.The papilla filling rate of square form was higher (P =0.007 ).Conclu-sion:The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained.Compared with triangle form,square form is found to favor a gingival papilla that fills the inter-proximal embrasure space.The consistency of the present classification method for upper central incisor is not satisfying,which indicates that a new classification method,more scientific and objective than the present one,is to be found.

Objective To evaluate the surgical technique and clinical significance of the therapy for ankle soft tissue defect with 2 different flee perforator flaps.Methods Twenty-five cases of ankle soft tissue defect with exposed bone of the ankle were involved in this study from August 2006 to April 2012.and the wound sizes varied from 4.0 cm × 5.5 cm to 11.0 cm × 23.0 cm.Twenty cases with acrotarsium soft tissue defect were repaired by free anterolateral thigh perforator flap,five cases with pelma soft tissue defect were repaired by free saphenous artery perforator flap.Results All Twenty-five flaps survived.At 3 to 50 months follow-up [on an average of (18.0 ± 0.8) months] postoperatively,appearance of the flaps was satisfactory,with 10 to 22 mm in 2-PD,and the sensation percentage beyond S2+ was 13/20 cases and 5/5 cases at 3 months follow-up,respectively.Conclusion The optimal therapy for the acrotarsium soft tissue defect is the free perforator anterolateral thigh flap,and free saphenous artery perforator flap should be used for pelma soft tissue defect.Avoid secondary orthopaedic surgery,pay more attention to the donor site of the flap.VSD can significantly promoting the survival rates of the free perforator flaps if the soft defects are caused by open injury.