ObjectiveTo study the effect of of oral powered microdedrider adenoidectomy with nasal endoscope in children with secretory otitis media. Methods74 children with secrctory otitis media treated with adenoidectomy with nasal endoscope randomly divided into group A 37 cases and group B 37 cases,the group A were treated with trans-oral adenoidectomy under endoscope, the group B were treated with trans-nasal adenoidectomy under endoscope,then the total effective rate,operation time, blood loss,incidence of complications and serum IgE, NO, IL-6,TNF-αand IL-2 of the two groups before and after the treatment were compared. ResultsThe cure, effective, and ineffective of group A were 34 cases ,3cases and 0 cases ,the total effective rate was 100.0％, the cure, effective,and ineffective of group B were 26 cases,7 cases and 4 cases,the total effective rate was 89.2％ ,the total effective rate of group A was significantly higher than that of group B( x2 =6. 869 ,P ＜0.05 ) ,the operation time of group A was( 8.6± 1.6) min, blood loss was( 12.3 ± 4. 1 ) ml, incidence of complications was 2.7％ ( 1 case postoperative hemorrhage), operation time of group B was ( 14.2 ± 2.1 ) min, blood loss was( 17.8 ± 3.5 ) ml, incidence of complications was 10.8％ (2 cases nasal adhesion and 2 cases postoperative hemorrhage) ,there were significant differences between the two groups ( t =5. 967,6.553, x2 =7. 142, all P ＜ 0.05 ), serum IgE, NO, IL-6,TNF-αand IL-2of the group A after the treatment were all lower than those of group B, ( t =5. 557,6. 348,5. 968,6. 976,5. 884, all P ＜ 0. 05 ).ConclusionThe effect of oral powered microdedrider adenoidectomy with nasal endoscope in children with secretory otitis media better,and it was worthy of popularization and application.

ObjectiveTo study the relationship between human papilloma virus(HPV) infections,p53 polymorphisms and esophageal cancer.MethodsA case-control study of 204 esophageal cancer cases (esophageal cancer group) and 102 healthy control cases (control group) biopsies were conducted to extract DNA,detected the HPV by PCR method and analyzed p53 polymorphisms by PCR-RFLP method,then analyzed the relationship between them and esophageal cancer incidence rate.ResultsThe positive rate of HPV16 in esophageal cancer group[59.3％(121/204)] was higher than that in control group [11.8％ ( 12/102 ) ] (P ＜ 0.05 ).And the frequency of Arg/Arg genttype of p53 in esophageal cancer group [ 51.5％ (105/204) ] was higher than that in control group [ 19.6％ (20/102) ] (P ＜ 0.05 ).The frequency of Arg/Arg genotypo in HPV16 positive patients [66.9％(81/121 )] was higher than that in HPV16 negative patients [ 28.9％ (24/83)] (P ＜ 0.05).ConclusionsHigh risk HPV phys an important role in development of esophageal cancer,p53 Arg/Arg genotype is one of high risk genetic factors for HPV-associated esophageal cancer.

BACKGROUND:Granulocyte colony-stimulating factor (G-CSF) can strongly mobilize bone marrow hematopoietic stem cells (HSCs). It has been proved that G-CSF has the ability to mobilize both HSCs and mesenchymal stem cells (MSCs).OBJECTIVE:To investigate the therapeutic effect of G-CSF in mobilizing autologous bone marrow stem cells entering cerebral infarction zone on ischemic cerebral infarction in rats.DESIGN:A randomized grouping design, animal experiment.SETYING: Center for Stem Cell Biology and Tissue Engineering of Sun Yat-sen University.MATERIALS: This experiment was carried out at the Animal Experimental Department of Sun Yat-sen University (North District) and Center for Stem Cell Biology and Tissue Engineering of Sun Yat-sen University from September 2004 to January 2005. Totally 200 male Wistar rats were chosen and randomly divided into autologous bone marrow stem cells transplantation group and control group, with 100 rats in each group.METHODS:Rats of two groups were made cerebral infarction models by line occlusion. Transplantation group introduced intraperitoneal injection of 60 μg/kg G-CSF one hour after operation. The control group introduced intraperitoneal injection of saline of the same dosage at the same time. ①All rats were weighed before operation and 24 hours, 48 hours, one week after operation to evaluate body mass loss rate. They were also given neurological grading. Grading criteria: Grade 0 is normal. Grade Ⅰ is that the right forelimb bends. Grade Ⅱ is that the right forelimb grasped weakly when the tail is lifted. Grade Ⅲ is that the rat has no directivity in automatic action and circumrotates to right when the tail is lifted. Grade Ⅳ is that the rat circumrotates to right in automatic action. ②15 rats in each group were selected. 24 hours, 48 hours, one week after operation, we opened the skulls, took out the brain and used 2,3,5-Triphenyltetrazoluim Chloride (TTC) staining to measure infarction volume, hematoxylin-eosin(HE) staining to observe the pathological change , and immunohistochemistry to detect the infiltration of CD34+ cells.MAIN OUTCOME MEASURES:Body mass loss rate, neurological grade,infarction volume, pathological change and infiltration of CD34+ cells.RESULTS: Totally 180 of 200 rats were successfully made cerebral infarction model. 48 rats died in seven days after operation. As a result, 132 rat models were alive and 120 rats were randomly selected for data analysis. ①Measurement of body mass and neurological grading: There was no significant difference in body mass loss rate between two groups 24 hours and 48 hours after operation (P ＜ 0.05);one week after operation, body mass loss rate was significantly lower in transplantation group [(10.5±8.2)%]than in control group [(17.8±7.1)%] (P ＜ 0.05). There was no significant difference in neurology grade between two groups. ②Infarction volume:Infarction volume and the percent of infarction volume in the whole brain in control group were all higher than those in the transplantation group,with significant difference [ (251.69±52.77) mm3 vs(145.72±28.05)mm3,(17.00±2.69)% vs (9.90±1.62)% ,P ＜ 0.01]. ③Pathological change: 24 hours after operation, the brain tissue of two groups got classical pathological change of cerebral ischemia infarction. There were some mono-nucleus cells infiltrating in transplantation group while none in control group. 48 hours after operation, most nerve cells disappeared and the glial cells were degenerated. There were many mono-nucleus cells infiltrating in transplantation group while a few in control group. One week after operation, tissues in the infarction zone were liquescent with many monocaryons and lymphocytes infiltrating around them in control group. In transplantation group, part of the infarction zone was plerosised through proliferation of newly born capillaries and glial cells and inflammatory cells were not evident. ④Immunohistochemistry: CD34+ mono-nucleus cells were detected in the ischemic territory in transplantation group 24 hours after operation while none in the brain of other side and control group. There were CD34+ mono-nucleus cells and pyramidate cells with mutations in transplantation group 48 hours after operation while none in the brain of other side and control group.CONCLUSION:The stem cell transplantation in situ therapy, which employs self-marrow stem cells mobilized by G-CSF can relieve the ischemic degree and reduce the infarction volume.

AIM:To investigate the potential of differentiatng into myocytes of the granulocyte colony-stimulating factor(G-CSF)-mobilized CD34 + cells. METHODS: Three hours after intraperitoneal injecction of isoprenaline(ISO) to develop acute ischemic model, rats' bone marrow hematopoietic stem cells were mobilized to the site of myocardial infarction by G-CSF. The techniques of immunohistochemisty and HE stain were used to detect the infiltration of CD34 + cells and the regeneration of myocytes in the infarct zones. RESULTS: 24 hours after administration of ISO , a large amount of infiltrative monocytes and regenerative myocytes which were CD34 positive expression could be found in the infarct zones of the G-CSF treatment group, while majority of the infiltrative inflammatory cells in control group were neutrophils and there was no infiltrative cells and myocytes which were CD34 positive expressio, 2 weeks after administration of ISO, there were a plenty of scar in control group, but not in the G-CSF treatment group. CONCLUSION: G-CSF-mobilized CD34 + cells possess the potential to differentiate into myocytes and it may be used in treating acute myocardial infarction.

Objective To investigate the time and implant selection in conversion from external fixation to internal fixation of tibial shaft fracture.Methods Data of 57 cases of tibial shaft fracture fixed externally followed by internal fixation from February 2003 to February 2012 were analyzed.Internal fixation (intramedullary nails or plates) initiated within 2 weeks (Group A,n =.35) and over 2 weeks (Group B,n =22) were compared in outcomes.Results One infection (3％) and four poor bone healing (11％) were observed in Group A.Five infections (23％) and three poor bone healing (14％) occurred in Group B.For intramedullary nail fixation,no infection was observed in Group A but infection rate of44％ was found in Group B.For plate internal fixation,infection rate was 8％ for both groups.Conclusions The conversion from internal fixation to internal fixation had better start within 2 weeks,with better resuhs,lower rate of infection and safer in comparison with that over 2 weeks.In addition,pin-tract infection is the high risk factor for infection after the conversion of the fixation.

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

Objective To investigate the roles of oxidative stress and inflammatory reaction in pathogenesis of endothelial dysfunction and atherosclerosis in patients with chronic renal failure(CRF).Methods 63 CRF patients were divided into non-dialysis group and hemodialysis group and 27 healthy volunteers were involved in the study.The levels of plasma malondialdehyde(MDA) were determined by thiobarbituric acid reaction,the activity of glutathione peroxidase(GSHPx) was mearsured by spectrophotometry,plasma nitric oxide(NO),high-sensitive C-reactive protein(hs-CRP),endothelin-1(ET-1) and tumor necrosis factor(TNF)-? were determined by sensitive enzyme-linked imunosorbent assay(ELISA).Results Levels of plasma MDA,hs-CRP,IL-6,TNF-?and ET-1 in CRF patients were higher than those in healthy controls,while NO,GSHPx were lower than those in healthy controls and hemodialysis aggravated these changes.Multivariate stepwise regressive analysis showed that ET-1,vWF and NO were related to MDA,TNF-?,hs-CRP,Cr(R2=0.502,0.631,0.476,respectively,P

Objective To investigagte the effect of high dose folic acid(FA) combined with vitamin B_(12) to homocysteine plasma level in maintenance hemodialysis(MHD) patients.Methods 52 MHD patients were randomly divided into 4 groups,receiving of FA 0,15,30,60mg/d orally for 3 months and those who receiced folic acid were given vitamin B_(12) 500?g/d,im.The levels of plasma FA,vitamin B_(12) and total homocysteine(tHcy) at 0,1,2,3,6 month were detemined by radioimmunoassay and flurescence polarization immunoassay respectively.Results Levels of tHcy in MHD patients were significantly higher than those in healthy controls.Both high dose and low dose FA could lower tHcy plasma concentrations,but had no significant difference in homocysteine reduction ratio,and could not normalize it.Three doses of FA combined with vitamin B_(12) treatment could effectively increase the plasma FA and vitamin B_(12) concentrations.Conclusion tHcy is elevated in the majority of MHD patients.Low dose of FA combined with vitamin B_(12) can decrease tHcy plasma levels,but cannot normalize it.

Objective To evaluate the different value of color Doppler ultrnsonography and Doppler vascular examinations in diagnosis for deep venous thrombosis(DVT)in the lower extremities.Methotis Imaging of color Doppler ultrasound scanning was employed as diagnostic criteria for DVT on 178 lower extremities of 146 suspected patients,as compared to the result by Doppler vascular examinations.Results Color Doppler ultrasonograph showed hish accuracy in diagnosis for DVT,as compared to that by Doppler vascular examination with 97.9 percent(142/145)positive for the femoral and popliteal veins and relatively lower positive diagnostic vallie for thrombosis in the inferior vena cava,iliac vein,anterior tibial vein,posterior tibial vein and calf veins.Conclusions Color Doppler ultrasonography is superior to Doppler vascular examination in determining DVT of the lower extremities and can be used as a main diagnostic method for it.Doppler vasculiar examination can be used as an initial screening method for DVT and deep venous angiography should not be used as a routine diagnostic measure for it.

Objective To evaluate the diagnostic role of color Doppler ultrasonogarphy(CDU),Doppler ultrasound(DU)in the diagnosis of lower extremity deep venous thrombosis(DVT). Methods In this study,84 patients(92 lower extremities)of lower extremity DVT were underwent CDU and DU and lower extremity deep venous angiography respectively. Results Total consistent rate,sensitivity,specificity,omission diagnostic rate,mistake diagnostic rate,Youden index,Odd product.positive predictive value,negative predictive value and Kappa of CDU in diagnosing lower extremity DVT was respectively 96.7%,95.7%,97.8%,4.3%,2.2%,0.935,990.0,97.8%.95.7%and 0.935(P=0.037).As Kappa of CDU(0.935)＞0.75 and its P(0.037)＜0.05.CDU can theoreticallv substitute for deep venous angiography;Above-mentioned indexes of DU were respectively 89.1%,87.2%,91.1%,12.8%,8.9%,0.783,70.0,91.1%,87.2%and 0.783(P=0.065). Conclusion CDU iS becoming preferred and more reliable noninvasive method in diagnosing lower extremitv DVT.