Humans ; Meniere Disease ; surgery

Group cooperative learning is a modem education model.In order to prompt the exploration of the education model in the practice lesson of epidemiology,group cooperative learning method was adopted.There are five key steps for the conduction of group cooperative learning,including task assignment(learning points,research topics,and infomation retrieval) 3-5 days before the task is done,reviewing the key theoretical contents,requiring students to refer to inf'ormation; organizing students to review the theoretical knowledge; students' discussion and making PPT in small groups,team report by representatives,and summing up by teachers at last.Teachers should pay attention to the rationality of interior structure and group members' work.Choosing a proper research subject is very important for arousing the students' interest of study.Based on the active classroom atmosphere and students' feedback,group cooperative learning method plays an important role in promoting the teaching efficiency of practice lesson.However,there are still insufficiencies to be improved.

Objective To examine the practicability and security of the LigaSureTM vessel-sealing system in radical gastrcctomy.Methods Seventy patients of stage Ⅰ～Ⅲ gastric cancer undergone radical gastrectomy were analyzed retrospectively.Thirty-five radical gastrectomy were performed with LigaSureTM vessel-sealing system,the other 35 eases were performed without LigaSureTM.The operative duration,volume of intraoperative hemorrhage,and postoperative complications were analyzed.Results There were significant difference in both operative duration[(159.9±24.7)min vs(172.6±23.7)min,P＜0.05]and volume of intraoperative hemorrhage[(335.7±40.3)ml vs(371.7±43.2)ml,P＜0.01].There was no significant difference in the postoperative complications between LigaSureTM group and conventional method group.All patients recovered without severe postoperative complications.Conclusion Radical resection of gastric cancer using LigaSureTM instead of conventional hand tie method appears to he shorten operative duration,decreased volume of intraoperative hemorrhage.And the technique is convenient and safe.

Objective To evaluate the embolization efficiency,short term clinical effect and adverse reactions of trisacryl gelatin microspheres in interventional treatment of hepatic carcinoma. Methods Twenty three cases of hepatic carcinoma (34 foci)were given 0.5-6 ml of microspheres mixed with some contrast medium via catheter after injection of chemodrugs and lipiodol 3-5 ml; and simultaneously observing the appearance of slow down of blood flow and vascular cast formation to stop the procedure. Enhanced CT or MR and AFP were performed every 1 month after the first procedure. Treatment needed to be repeated whenever the foci or new ones were enhanced in CT scans or increase of AFP value. The clinical effect and adverse reactions were also observed. Results The positive response rate was 39.1% (CR+PR). There were 9 cases of PR,13 cases of NC and 1 of PD; but no case of CR. Residual enhancement was observed in 17 foci after first procedure,10 of which received repeated therapy and 3 were embolized completely. The other 11 foci were completely embolized,among them 4 had new residual enhancement during 4-9 mo follow up and 2 were re-embolized completely. Eighteen cases with positive AFP showed obvious decrease in 11,no change in 6 and increase in one. Eighteen cases of pyrexia,11 cases of pain in hepatic region and 6 cases of nausea occurred 5-14 d after the procedure together with vomiting. We also found increase of ALT in 2 cases,BIL of 1 case,and no change of WBC in all cases. Conclusion Trisacryl gelatin microspheres is an excellent embolization agent with better clinical effect and less adverse reaction in the treatment of hepatic carcinoma.

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Objective:To explore the clinical value of dynamic posturography in the diagnosis of peripheral vertigo. Method:One hundred and sixty peripheral vertigo patients with full clinical documents in vertigo clinic of our hospital from May 2007 to May 2008 were retrospectively analyzed in this study. All the patients firstly underwent the inspection of static and dynamic posturography and then were subjected to caloric test using videonystagmogra-phy. The results were conducted a comparative analysis. Surface of the statokinesigram (SSKG) was selected as assessment parameter of static posturography. The result of sensory organization test (SOT) were selected as assessment parameters of dynamic posturography. The unilateral weakness was selected as assessment parameter of caloric test. Twenty normal subjects were selected as control. Result: Among the 160 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 144 cases, with a sensitivity of 90. 0%; caloric test was abnormal in 110 cases, with a sensitivity of 68. 8%; static posturography was abnormal in 76 cases, with a sensitivity of 47. 5%. There existed a statistically significant difference between dynamic posturography and caloric test or static posturography. There were 40 patients(25. 0%) who had normal caloric test results in which dynamic posturograph findings were abnormal. Among the 20 cases of normal people, results of SOT in dynamic posturography were abnormal in only one case(5. 0%). Conclusion:With its superior sensitivity and specificity, dynamic posturography has been an objective and reliable approach in the diagnosis of peripheral vertigo. It can help to confirm the presence of abnormalities in some peripheral vertigo patients whose caloric results are normal.

The goal of treatment of metabolic syndrome is the prevention of diabetes and cardiovascular events. A series of novel tetrahydrocoptisine quaternary ammonium compounds were prepared to evaluate their action of hypoglycemia and hypolipidemia for finding the therapeutic agents of metabolic syndrome. Starting from the coptisine hydrochloride (2), fifteen target compounds were synthesized by reduction and substitution of the 7-N position. All of the target compounds were characterized by 1H NMR and HR-MS. Their hypoglycemic activities were evaluated in HepG2 cell and hypolipidemic activities of compounds with better hypoglycemic activity were tested further in vivo. Results indicated that compounds 5, 7, 8 and 9 exhibited better hypoglycemic activities in vitro and compounds 5 and 8 exhibited good hypolipidemic activities in high-fat-diet (HFD) induced hyperlipidemia mice and (or) hamsters. However, the activity is not as good as simvastatin.

ObjectiveTo summarize the echocardiographic diagnosis, clinical classification and prognosis of different types of fetal congenital cardiac malformation (FCMH).MethodsThe echocardiography sonogram characteristics for 429 cases with FCMH were summarized and analyzed by pathological findings and postnatal following-up.ResultsThe incidence of FCMH was 1.3% (429/33 800). In one hundred and seventy-seven caese of single structure malformation, there were 5 cases of Atrial septal defect and 55 cases of interventricular septal defect (34.5%, 61/177). The others including (116 cases): 10 cases of single atrium and 34 cases of single ventricle, 20 cases of Ebstein’s anomaly, 11 cases of tricuspid atresia and 6 cases of pulmonary atresia with intact ventricular seprum, 20 cases of pulmonary stenosis, 10 cases of coarctation of aortic arch and 4 cases of interruption of aortic arch, 1 case of pulmonary artery sling. In two hundred and thirty-three cases of symphysic teratism, there were 41 cases of double-outllet right or left ventricle (17.5%, 41/233) and Tetralogy of Fallot (40 cases, 17.2%, 40/233). The others (152 cases) including: 16 cases of complete and 18 cases of corrected transposition of great arteries, 38 cases of atrioventricular septal defect, 30 cases of truncus arteriosus persistens, 8 cases of total and 10 cases of partial abnormal pulmonary venous drainage, 14 cases of hypoplastic right heart and 6 cases of left heart syndrome, 9 cases of pulmonary artery atresia with ventricular septal defect, 2 cases of plysplenia and 1 case of plenia syndrome. Nineteen cases of instructure cardiac anomalies including 16 cases of heart tumor and 3 cases of endocardial ifbroelastosis. Nine cases were missed diagnosis and 7 cases were misdiagnosis. A total of 136 cases couldn′t be cured with an unfavorable outcome. Nighty three cases with severe FCMH could be cured. Fifty four cases needed emergent treatment postnatal, and 146 cases with mild abnormality.ConclusionsFetal congenital malformation of heart diagnosed by antenatal echocardiography is valuable for guiding the clinical decision in prevetion and treatment it can also reduce perinatal mortality with congenital malformation of heart.

We developed a three-dimensional finite element model of the pelvis. According to Letournel methods, we established a pelvis model of T-shaped fracture with its three different fixation systems, i. e. double column reconstruction plates, anterior column plate combined with posterior column screws and anterior column plate combined with quadrilateral area screws. It was found that the pelvic model was effective and could be used to simulate the mechanical behavior of the pelvis. Three fixation systems had great therapeutic effect on the T-shaped fracture. All fixation systems could increase the stiffness of the model, decrease the stress concentration level and decrease the displacement difference along the fracture line. The quadrilateral area screws, which were drilled into cortical bone, could generate beneficial effect on the T-type fracture. Therefore, the third fixation system mentioned above (i. e. the anterior column plate combined with quadrilateral area screws) has the best biomechanical stability to the T-type fracture.
Biomechanical Phenomena ; Bone Plates ; Bone Screws ; Finite Element Analysis ; Fracture Fixation, Internal ; Fractures, Bone ; pathology ; Humans ; Models, Anatomic ; Pelvis ; anatomy & histology ; injuries ; Posture

Objective To investigate the risk factors for persistent hemodynamic depression after carotid angioplasty and stenting(CAS). Methods Sixty-one patients with CAS were included. By univariate Logistic regression analysis,the influencing factors for persistent hemodynamic depression were analyzed,by stepwise Logistic regression analysis and adjustment for age and gender factors,the independent risk factors for persistent hemodynamic depression were analyzed. Results In 61 patients,25 cases had hypotension,25 cases had bradycardia,all for 41.0% incidence. According to the patients intraoperative and postoperative blood pressure,heart rate conditions,the duration of hemodynamic depression,the cases were divided into persistent hemodynamic depression group (20 cases) and no-persistent hemodynamic depression group(41 cases). Univariate Logistic regression analysis indicated that persistent hemodynamic depression influencing factors were the symptomatic stenosis, severe stenosis, using balloon dilatation, implantation of laser-carving stent(P<0.05). With adjustment for age and gender factors, stepwise Logistic regression analysis showed that using balloon dilatation, implantation of laser-carving stent were the independent risk factors for persistent hemodynamic depression (OR = 5.046,95%CI 1.342-18.977,P = 0.017;OR = 4.142,95%CI 1.151-14.902, P= 0.030),symptomatic stenosis was the independent protective factor for persistent hemodynamic depression (OR = 0.264,95% CI 0.073-0.964,P= 0.044). Conclusions Persistent hemodynamic depression after CAS is a common complication.CAS patients with using balloon dilatation, implantation of laser-carving stent are more susceptible to persistent hemodynamic depression, while symptomatic stenosis is its protective factor.