OBJECTIVE To investigate the significance of diagnosis of tempanosclerosis by HRCT combined with pure tone audiometry. METHODS 176 patients(181 ears) with chronic suppurative otitis media in stationary phase were recruited in Guizhou Medical University Affiliated Hospital between January 2014 to December 2015. Temporal bone HRCT combined with pure tone audiometry were applied to all patients before operation to diagnose tempanosclerosis. Intraoperative exploration results was the gold standard to observe sensitivity, specificity, positive likelihood ratio and the difference of accuracy of two diagnostic methods. RESULTS 1. The sensitivity, specificity, positive likelihood, negative likelihood ratio and accuracy of tympanosclerosis diagnosed only by temporal bone HRCT were 58.55%, 93.10%, 8.49, 0.46 and 64.09% respectively. 2. The sensitivity, specificity, positive likelihood, negative likelihood ratio and accuracy of tympanosclerosis diagnosed by HRCT combined with pure tone audiometry were caculated as 94.08%, 89.66%, 9.09, 0.01 and 93.37% respectively. Type I diagnostic accordance rate was 89.66%, type II was 87.50%, type III was 84.62%and type IV was 82.14%. The total diagnosis coincidence rate was 86.18%. The diagnostic efficacy increased significantly by the combined method than by the temporal bone HRCT alone. CONCLUSION Temporal bone HRCT combined with pure tone audiometry is valuable in diagnosis of tympanosclerosis. It can provide theoretical basis for making optimal operation scheme in suspect tympanosclerosis patients.

Objective To study the factors affecting preverbal communication skill in prelingually deaf children with cochlear implants.Methods A total of 31 prelingually deaf children with cochlear implantation participated in the study.They received cochlear implantation the age of 12 months with a mean of 46.71 months.The video analysis were applied to assess the preverbal communication skill including rurn-taking,autonomy,eye contact and auditory awareness.According to the implant age,preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing.Wilcoxon signed-rank test was used to evaluate the differences among the groups.The implant age distribution:16 cases in ≤36 months group;15 cases in >36 months group.Preoperative speech rehabilitation training (recovery time more than 3 months) : 14 cases in rehabilitation group, 17 case in no rehabilitation group.Preoperative surgerg ear averrage residual hearing:6 cases in ≤80 dB HL group;25 cases in >80 dB HL group.Preoperative use of hearing aids (use time more than 3 months) distribution: 21 cases in use group, 10 cases in no use group.Results There was statistical signifficance in preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing(P<0.05)and there was no statistics significance group of implant age(P>0.05).Conclusion Preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing in prelingually deaf children with cochlear implants relate with better preverbal communication still.

Objective:To assess the association between particulate air pollution and hospital admissions for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing, and to eva-luate the differences of association among different subgroups.Methods: Hospital admissions to intertiary hospitals for AECOPD from January 1,2014, through December 31, 2015 were obtained from the electronic hospitalization summary reports (HSRs).We obtained the data on air pollution during the study period from the national air pollution monitoring system.The data on meteorological variables were obtained from the Chinese meteorological bureau.A poison generalized additive model was used to assess the effects of particulate pollution on AECOPD with adjustment for the long term trend, day of week, holiday effect and meteorological variables.Subgroup analyses were also conducted by age and gender, which would help identify higher-risk groups.Results: A total of 7 884 hospitalizations from 15 tertiary hospitals were recorded during the study period, and 69.3% were male patients, 37.1% were ≥80 years of age, 45.5% were 65-79 years of age, and 17.4% were younger than 65.The mean (SD) daily concentrations of PM2.5, PM10 were 77.1 (66.6) μg/m3, 111.9 (75.8) μg/m3.Every 10 μg/m3 increase in particulate pollution concentration for a lag of 4 d was associated with an increase in hospital admissions for AECOPD as follows: 0.53% (95% CI: 0.01%-1.06%, P=0.0478) of PM2.5, 0.53% (95% CI: 0.07%-1.00%, P=0.0250) of PM10, respectively.We found differences in risk for AECOPD admissions among the different subgroups.For every 10 μg/m3 increase in PM2.5, PM10 exposure in the female group there was a 1.13% (95% CI: 0.19%-2.07%, P=0.018 3) increase, 1.06% (95% CI: 0.22%-1.91%, P=0.013 6) increase in admissions, respectively, while in the male group, the association was non-significant.The patients of 80 years of age and older demonstrated a hi-gher risk of AECOPD, 1.25% (95% CI: 0.40%-2.11%, P=0.004 0) increase of PM2.5, 1.18% (95% CI: 0.42%-1.95%, P=0.002 4) increase of PM10, respectively, while other subgroups didn't find significant association.Conclusion: Our findings showed that particulate air pollution was significantly associated with hospital admissions for AECOPD in Beijing.The susceptibility to particulate pollution varied by gender and age.

Objective:To describe the incidence, diagnosis rate, treatment rate and treatment pattern of hyperkalemia, and serum potassium retesting rate among hyperkalemia patients in the emergency department.Methods:Data were derived from Military Data Center for Rational Use of Drugs. Patients who accessed emergency medical services (≥18 years old) with record(s) of serum potassium between 2015 and 2017 were included. The data of laboratory test, diagnosis, and treatment were analyzed. The main outcomes included the incidence of hyperkalemia, the diagnosis rate, the treatment rate, treatment pattern and the 7-day retesting rate.Results:A total of 1 039 245 patients who met the above criteria were included, of whom, 36 615 (3.52%) had at least one hyperkalemia event. Among the emergency patients with chronic kidney disease, heart failure, diabetes mellitus and hypertension, the proportions of patients who experienced hyperkalemia were 47.69%, 29.13%, 21.69% and 10.16%, respectively. The diagnosis rate of emergency hyperkalemia patients was 9.23%. The overall hyperkalemia treatment rate was 42.1%. Insulin + glucose injection was the most commonly used therapy for emergency hyperkalemia patients. The overall serum potassium retesting rate within 7 days was 28.8%.Conclusions:Hyperkaliemia is more common and more severe in patients with chronic kidney disease, heart failure, diabetes and hypertension. The diagnosis rate and retesting rate of hyperkalemia are low, suggesting that the identification and management of hyperkaliemia in emergency patients should be strengthened.

Disease risk score (DRS) can be used to adjust the confounding effects on data with high dimensions and can reduce related bias through balancing the risk or probability,regarding the development of some specific diseases,between the two compared groups.The DRS approach thus can be applied to studies of pharmacoepidemiology when administrative medical database is used for data analysis.Although DRS functions are similarly to the propensity scores (PS) under many situations,even with some advantages over PS or conventional analytical methods in some special exposure settings,the usage of DRS is far limited than the PS method.Considering the important application value of DRS in pharmacoepidemiologic studies,we are introducing the theory,model,estimation and application of DRS,to present reference for the development of DRS method in the pharmacoepidemiologic studies.

OBJECTIVE: To detect the roles of Livin and its relationship with bFGF in laryngeal squamous cell carcinoma (LSCC) through observing the expression of Livin and bFGF in laryngeal squamous cell carcinoma. METHOD: Expression of Livin and bFGF in 41 cases of LSCC (11 cases with lymph node metastasis) and 20 cases of normal soft palate mucosa were detected by immunohistochemistry. RESULT: Livin were positively detected in 29 (70.73%) cases of LSCC and negatively detected in all normal soft palate tissue. The positive rate of Livin was higher in LSCC than that in normal soft palate tissue and the expressions were significantly associated with lymph node metastasis status (P < 0.05) but not with histological grade, clinical stage and age (P > 0.05). The expression of Livin was positively correlated with the expression of bFGF. CONCLUSION The elevated expression of Livin in LSCC might play an important role in the development of laryngeal squamous cell carcinoma and bFGF might be involved in the process.
Adaptor Proteins, Signal Transducing ; metabolism ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism

Objectives: . Nicotine is an ingredient of tobacco, and exposure to nicotine increases the risks of various cancers, including oral cancer. Previous studies have focused on the addictive properties of nicotine, but its carcinogenic mechanism has rarely been studied. We aimed to explore the key genes in the process through which nicotine promotes the occurrence and development of oral cancer via data mining and experimental verification. Methods: . This study involved three parts. First, key genes related to nicotine-related oral cancer were screened through data mining; second, the expression and clinical significance of a key gene in oral cancer tissues were verified by bioinformatics. Finally, the expression and clinical significance of the key gene in oral cancer were histologically investigated, and the effects of its expression on cell proliferation, invasion, and drug resistance were cytologically assessed. Results: . SERPINE1 was identified as the key gene, which was upregulated in nicotine-treated oral cells and may be an independent prognostic factor for oral cancer. SERPINE1 was enriched in various pathways, such as the tumor necrosis factor and apelin pathways, and was related to the infiltration of macrophages, CD4+T cells, and CD8+T cells. Overexpression of SERPINE1 was associated with N staging and may be involved in hypoxia, angiogenesis, and metastasis. Knockdown of SERPINE1 in oral cancer cells resulted in weakened cell proliferation and invasion ability and increased sensitivity to bleomycin and docetaxel. Conclusion . This study revealed SERPINE1 as a key gene for nicotine-related oral cancer, indicating that SERPINE1 may be a novel prognostic indicator and therapeutic target for oral carcinoma.

Objective To assess the association between Metformin use and the risk of dementia in patients with type 2 diabetes mellitus(T2DM).Methods The research data came from the big medical data platform of Yinzhou District,and we constructed a cohort of T2DM patients who had initiated treatment of Metformin or sulfonylurea since January 1,2009.The inverse probability of treatment weighting(IPTW)was used to control the baseline confounding factors,and the Cox regression model was used to estimate the HR(95%CI)of the association between Metformin use and dementia risk.Results The incidence rate of dementia in new users of Metformin(41181 persons)and sulfonylureas(38092 persons)was 128.4 per 100000 person years and 142.3 per 100000 person years respectively.Compared with sulfonylureas,the crude analysis with no adjustment for confounding factors showed that there was a negative association between the use of Metformin and the incidence of dementia,with an HR(95%CI)0.930(0.800～1.090).After adjusting for potential confounders with IPTW,Metformin was not significantly associated with the risk of dementia HR(95%CI)1.040(0.890～1.220).The subgroup analysis results for different baseline characteristics were consistent with the primary analysis results,and there were no statistically significant associations between Metformin and dementia incidence risk in all subgroups.Conclusions There is no significant association between the use of Metformin and the risk of dementia in T2DM patients in the Yinzhou District.

Objective To explore the risk of developing metabolic syndrome (MS) by using the data from cohorts involving people having received screening programs for physical check-up,in three areas of China (Beijing,Hongkong and Taiwan).Methods A total number of 6 828 non-metabolic syndromic adults,who received physical examination for the first time and with records kept for longer than 5 years (between 2004 and 2010) at the MJ centers,were recruited.Criteria developed by the Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Chinese Adults in 2007 (JCDCG-2007) was used for defining the metabolic syndrome.Cox proportional hazards regression model was used to examine the difference of the risk of developing MS among the three cohorts that received the health screening programs.Results The standardized incidence densities of MS were 3.14 per 100 person-years,2.19 per 100 person-years and 2.03 per 100 person-years in the cohorts of Beijing,Hongkong and Taiwan,respectively.After adjusting for gender,age,cigarette smoking,dietary patterns at the baseline,the HRs for people in Beijing and Hongkong were 1.60 (95％CI:1.34-1.91) and 1.08 (95％CI:0.83-1.41) respectively,in developing MS,when compared with people from Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake dietary pattern and MS components at the baseline all showed significantly positive effects on the risk of developing MS.Conclusions There were significant differences regarding the risk of developing MS among health screening people from the Beijing,Hongkong and Taiwan.Factors as being male,elderly,cigarette smoking,meat/food intake,dietary pattern and MS components at the baseline appear to be the risk factors for developing the MS.

Objective:To establish a multi-state Markov model of type 2 diabetes mellitus (T2DM) patients and explore the transition rule between the cumulative number of different chronic complications, estimate the transition probability and intensity between status, and explore the possible factors affecting the transition between status.Methods:A retrospective cohort study of 33 575 patients with T2DM was conducted. According to the baseline and the cumulative number of chronic complications during the follow-up period, the patients were classified based on five status: T2DM, one complication, two complications, three complications, four and above complication, indicated by S0, S1, S2, S3 and S4, respectively. A time-continuous and state-discrete multi-state irreversible Markov model was used for statistical analysis.Results:The study included 33 575 T2DM patients, and their average age was 60 years old, the median of follow-up length was 8 years. In these patients, 32 653 had no baseline complications. At the end of follow-up, the transition probabilities of S0→S1, S1→S2, S2→S3 and S3→S4 were 16.4%, 32.4%, 45.6% and 25.9%, respectively. The results of multivariate analysis showed that being female ( HR=0.919), less than 60 years old ( HR=0.929), higher fasting plasma glucose ( HR=1.601), lower high-density lipoprotein ( HR=1.087), higher total cholesterol ( HR=1.090),weekly exercise ( HR=0.897), vegetarian diet ( HR=0.852) and heavy diet ( HR=1.887) were the risk factors for S0 to S1. And being female ( HR=0.768), less than 60 years old ( HR=0.859) and lower high-density lipoprotein ( HR=1.160) were the risk factors for S1 to S2. Conclusions:The probability of multiple complications in T2DM patients increased over time, the transition intensity of S2→S3 was largest, followed by S1→S2. Therefore, we need to conduct both early and long-term indicators monitoring and disease prevention, strengthen the health education to improve patients' daily living habits at early stage of the illness, encourage patients to have moderate exercise and balanced diet, strengthen the monitoring of fasting blood- glucose, cholesterol and high-density lipoprotein levels to prevent the deterioration of the illness.