Objective To investigate the effect of cisplatin ototoxicity on apoptosis of spiral ganglion cells(SGC), and relation between signal transportation of Caspase-3 and apoptosis of SGC.Methods Forty guinea pigs were randomly divided into 4 groups, and injected cisplatin (1, 2, 4 day group and control group). ABR and AERP (40 Hz Auditory Event Related Potentials) were tested every day after the injection, to find out the threshold changes of guinea pigs. Apoptosis was detected by terminal deoxynucleotidyl transferase(TdT)-mediated deoxyuridine triphosphate(d-UTP) nick end labeling method (TUNEL), and immunohistochemistry method was used to detect Caspase-3 p20 segment of SCGs.Results It was observed that the more cisplatin injected, the worse hearing guinea pigs got, and the damnification of threshold on 8KHz was significantly higher than that on 1 kHz. At the same time, TUNEL staining and the expression of Caspase-3p20 segment rose up gradually, and significant difference was observed compared with control group ( P

Objective To study the Inflammation and immune stress of obese asthmatic rats by adipocytokines.Methods Fourty C57BL/6 J mice were randomly divided into control group, obese group, asthma group and obese asthma group.Mice in the control group were fed normal diet and PBS, high-fat diet(75% normal diet, 10% egg yolk powder, lard 10%, 5% sugar)and PBS in obese group, normal diet and OVA(PBS)in asthma group and fat diet and OVA(PBS)in obese asthma group.Detect the leptin, adiponectin, resistin, IL-4, IFN-γ, IL-17 content with ELISA in serum and bronchoalveolar lavage fluid(BALF).Using Pearson correlation to analyze and evaluate these factors' correlation in plasma and BALF.Results The difference of leptin, adiponectin, resistin in plasma and BALF(excepted leptin)between four groups were statistically significant (P<0.05), the leptin levels between plasma and BALF has a positive correlation(R2=0.8215, P<0.05)in obese mice, there was no correlation between plasma and BALF for the adiponectin, resistin.The adiponectin content and IFN-γ levels were also negatively correlated(R2=0.9146, P<0.05)in BALF, while there was no correlation between IL-4,IL-17 and leptin, adiponectin, resistin.Conclusion Adipocytokines has a regulatory function of the immune response in obese asthmatic rats, and participate the inflammatory reaction.

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

OBJECTIVE:To evaluate the effects of PDCA cycle management method on clinical application of Fat-soluble vita-min for injection (Ⅱ). METHODS:By retrospective analysis,500 discharge medical records of Fat-soluble vitamin for injection (Ⅱ)were collected from our hospital during Jul.-Aug. in 2015(before intervention),Sep.-Oct. in 2015(after first intervention cy-cle),Nov.-Dec. in 2015(after second intervention cycle),respectively. RESULTS:After 2 PDCA cycles,the proportion Fat-solu-ble vitamin injection (Ⅱ) use without indication decreased from 65.4% to 39.2%;the reasonable rate of drug dosage increased from 53.2% to 97.2%,and that of usage increased from 96.4% to 99.8%;the reasonable rate of medication course increased from 69.6% to 96.6%;the reasonable rate of the clinical application of Fat-soluble vitamin injection (Ⅱ) increased from 18.8% to 56.4%,with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle can effectively promote the clinical reasonable of Fat-soluble vitamin for injection(Ⅱ).

With the development of tissue engineering,the bone tissue engineering is developing rapidly. Engineering hone typically uses an artificial extracellular matrix (scaffold),osteoblasts or progenitors,and os- teoinductive factors which promote cell attachment,differentiation,and mineralized bone formation.Highly porous scaffolds play a critical role in cell seeding,proliferation,and new 3D-tissue formation.A variety of biodegradable polymer materials and scaffolding fabrication techniques for engineering bone have been developed over the past decade.This article reviews the scaffold design and fabrication methods tor engineering bone to analyze their ad- vantages and limitations.Various architectural parameters of scaffolds important for bone tissue engineering (e.g. porosity,pore size,interconnectivity) are discussed.

Objective To study the relationship of surgical procedures with clinical effect in herniat-ed lumbar disc in order to improve operative methods and obtain a better outcome.Methods Retrospec-tive analysis was carried out in7235patients with herniated lumbar disc,who had been operated by removal of nucleus pulposus using small incision and fenestration in our hospital since1983,313cases of whom re-ceived second operation because of postoperative complications.There were187males and126females aging from27to62years(mean,45.8years),the incidence of morbidity was4.32%.During the same period,552patients,who had less approved operative result primarily treated in other hospitals,were admitted to our hospital.There were317males and235females aging from31to64years(mean,46.0years).Results The postoperative complications could be divided into short term(within1month after operation)and mid-dle to long term(more than1month after operation)groups.The total446cases with short term compli-cation were133cases primarily treated in our hospital and313cases in other hospital,including of re-herni a-tion or incomplete nuclear extirpation in77treated with second operation,discitis in106treated with con-servative therapy for 67and second operative management for 39,canal hematoma compression in76treated surgi cally,multi-level herniation and leakage in21and mislocalization in59re-operated,injury of nerve root or cauda equina in85treated with nerve exploration,release and anastomosis,residual materials in canal in17with removal of foreign body,venous thrombus in2,and arachnoiditis in3.The total424cases with middle to long term complications were185cases primarily treated in our hospital and239cases in other hospitals,including of nerve root adhesion in159,recurred disc herniation in122,segmental instability in81,and ia-trogenic spinal stenosis in62.Conclusion Many factors may influence the outcome of herniated lum bar disc which can be abolished by sufficient preparation,careful operation and proper managememt.

BACKGROUND: Acellular dermalmatrix (ADM), as a new material, is generally applied to tissue repair after head and neck tumorectomy. However, hypopharyngeal carcinoma surgery always involves in repair and functional reconstruction of defected tissue; therefore, the application effect of ADM needs to be further studied for repairing laryngopharynx defect. OBJECTIVE: To evaluate the clinical effect of ADM in repairing laryngopharynx defect following tumorectomy. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Department of Otolaryngology-Head and Neck Surgery, Institute of Battle Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA from May 2005 to June 2006.PATICIPANTS: A total of 25 male cases aged 45-68 years including 22 patients with tumor in the lateral wall of the unilateral piriform fossa and 3 patients with in the posterior wall of laryngopharynxat were finally diagnosed as squamous cell carcinoma. METHODS: According to clinical stages, patients underwent partial or complete laryngopharyngectomy. ADM was used to repair oropharynx mucosa following the laryngopharyngectomy. However, ADM alone was used to repair piece-shaped oropharynx mucosa, limiting by being unable to complete reconstruction of spatial structure. Therefore, myocutaneous flap or other materials combined with ADM was beneficial for reconstruction of laryngopharyngeal cavity following complete laryngopharyngectomy. MAIN OUTCOME MEASURES: The effect of ADM on functional reconstruction of swallowing, breathing, and pronouncing. RESULTS: A total of 25 patients were included in the final analysis. No patients suffered with the pharyngeal fistula. Only one case encountered the subcutaneous infection at day 20 after surgery, but recovering after regular change of dressing and treatment of antibiotics. About 15 patients who accepted the surgery of partial laryngopharyngectomy suffered with bucking, but after 30-60 days, the symptom relieved, even disappeared, in spite of 3 cases still bucking when they swallowed liquid diet. Breathing function was recovered, and tracheal cannula was removed 6-12 months after surgery. Ten of them who accepted total laryngopharyngectomy had resumption of normal oral diet after 20 days. The follow-up periods after the surgery lasted 12-30 months. The allograft became normal mucosa finally, without rejection or scar formation. The follow-up of 10 patients lasted more than 24 months, one case had relapse of tumor, still alive after the second surgery. CONCLUSION: ADM with perfect histocompatibility and easy operability, can be applied to repair deletion of laryngeal or pharyngeal tissue and recover functions of pronouncing, breathing, and swallowing after tumorectomy. The combined use of ADM and musculo-cutaneous flap was effective and satisfactory.

Objective To explore the clinical effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury.Methods Fifty elderly cardiac surgery patients with postoperative acute kidney injury were divided into control group and study group by random digit table method with 25 cases each.The 2 groups were treated with routine drug and blood purification,the study group was additionally given fasudil injection 30 mg + 0.9％ sodium chloride injection 50 ml vein pumping,1 time/12 h,for 7 d.The urine volume,urine N-acetyl-β-D-glucosaminidase (NAG),urine γ-glutamyl transpeptidase (γ-GTP),urine α 1-microglobulin (α 1-MG),serum creatinine (SCr),blood urea nitrogen (BUN) and creatinine clearance rate (CCr) were observed,and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was computed.Results There were no statistical differences in the indexes before treatment between the 2 groups (P＞ 0.05).The urine volume after treatment 3,5,7 d in study group was more than that in control group [(38.72 ± 2.68) ml/h vs.(31.68 ± 2.52) ml/h,(47.24 ±3.73) ml/h vs.(40.24 ± 2.52) ml/h、(63.80 ± 2.50) ml/h vs.(56.60 ± 3.30) ml/h],urine NAG,urine α 1-MG,urine γ-GTP,SCr and BUN were lower than those in control group [NAG:(25.05 ±5.44) U/L vs.(28.04 ± 5.21) U/L,(24.06 ± 3.43) U/L vs.(27.23 ± 6.43) U/L,(22.08 ± 3.25) U/L vs.(26.23 ± 4.41) U/L; α 1-MG:(24.05 ± 3.65) mg/L vs.(26.74 ± 6.74) mg/L,(22.98 ± 3.58) mg/L vs.(25.57 ± 3.58) mg/L,(20.95 ± 3.78) mg/L vs.(25.48 ± 3.45) mg/L; γ-GTP:(8.2 ± 0.4) U/L vs.(10.8 ± 3.8) U/L,(7.3 ± 0.2)U/L vs.(10.5 ± 2.5) U/L,(6.5 ± 1.4) U/L vs.(9.7 ± 2.6) U/L; SCr:(206.52 ± 6.72) μ mol/L vs.(255.16 ±6.75) μmol/L,(182.98 ±6.26) μmol/L vs.(252.23 ±9.53) μmol/L,(33.25 ±7.95) μmol/L vs.(170.75 ± 7.94) μ mol/L; BU N:(19.61 ± 3.23) mmol/L vs.(20.25 ± 3.25) mmol/L,(16.76 ± 2.06) mmol/L vs.(18.32 ± 4.84) mmol/L,(12.28 ± 2.26) mmol/L vs.(14.27 ± 4.54) mmol/L],CCr was higher than that in control group [(18.66 ± 3.89) ml/min vs.(13.28 ± 3.25) ml/min,(27.76 ± 4.36) ml/min vs.(16.23 ± 4.18)ml/min,(33.79 ± 5.58) ml/min vs.(22.12 ± 4.65) ml/min],there were statistical differences (P ＜ 0.05).The APACHE Ⅱ score before treatment and after treatment 5,7 d in control group were (32.20 ±4.51),(26.38 ±5.28) and (21.43 ±4.22) scores,in study group were (33.05 ±3.82),(22.15 ±3.42) and (13.25 ± 2.15) scores.There was no statistical difference in the APACHE Ⅱ score before treatment (P ＞ 0.05),the APACHE Ⅱ score after treatment was improved,furthermore APACHE Ⅱ score after treatment 5,7 d in study group were better than those in control group,there were statistical differences (P ＜ 0.05).Conclusions The treatment effect of blood purification combined with fasudil is remarkable in elderly cardiac surgery patients with postoperative acute kidney injury.At the same time,it has high security and very important clinical significance.

Objective To investigate the amlodipine or hydrochlorothiazide and valsartan combination thera-py in elderly hypertensive patients with blood pressure variability ( BPV ) and nitric oxide ( NO ) , endothelin role. Methods 552 elderly patients with hypertension were divided into the observation group and control group,276 cases in each group,the observation group was given amlodipine valsartan for treatment,while the control group was received hydrochlorothiazide combined with valsartan for treatment,the two group were treated for three months,the content of BPV,NO and plasma endothelin were analyzed.Results After treatment,the 24hSBPV,day SBPV,24hDBPV,day DBPV of the observation group significantly decreased compared with pre-treatment, the difference was statistically significant(t=20.09,15.97,9.31,9.41,all P<0.05),patients in the control group only 24hSBPV and day SBPV [(9.12 ±2.57)%,(8.43 ±1.97)%]were significantly lower than before treatment(t=12.31,9.53,all P<0.05);The day SBPV,24hDBPV,day DBPV[(7.21 ±1.34)%,(12.31 ±2.54)%,(10.59 ±2.73)%]of the ob-servation group after treatment were significantly lower than those of the control group(t=10.52,12.34,8.35,all P<0.05);The NO[ (66.12 ±23.57)%,(68.29 ±21.52)%]and endothelin levels[(34.43 ±7.97)%,(34.21 ± 7.34)%]of the two groups after treatment were significantly lower than those of before treatment(tobservation grou P=31.39,11.79,tcontrol grouP=28.31,9.35,all P<0.05).Conclusion The amlodipine or valsartan hydrochlo-rothiazide used clinically can effectively control blood pressure, significantly increase NO levels, decrease plasma endothelin levels,which is worth to be used in the clinical.

Objective To evaluate the safety of Fotemustine. Methods The studies had been done according to the experimental method of injection agents in pharmacodynamics guide principle on toxic test methods of application. The vascular stimulative assay of fotemustine injection on rabbit, the hemolyzation or agglutination of it in vitro, and the allergic reaction on guinea pig were performed. Results It was showed that the Fotemustine injection had no vascular irritation and injury effect on rabbit vascular endothelial cell. Compared with that of the control group, there was no difference. Conclusion No evidences of hemolyzation and aggregation on rabbit erythrocyte, and no allergic reaction on guinea pig were observed.