Objective To explore the characteristics of auditory brainstem response(ABR) in children with otitis media with effusion(OME) before and after myringotomy with grommet insertion and the significance of ABR in diagnosing OME.Methods ABR were recorded in 50 cases(100 ears) before receiving myringotomy with grommet insertion for OME,30 cases(60 ears) underwent ABR monitoring after surgery again.For comparison,50 age-matched healthy children(100 ears) were also tested with ABR.Furthermore,30 cases were divided into two groups according to the viscidity of tympanic cavity secretion and the response threshold of wave Ⅴ were compared between the two groups.Results The response threshold of wave Ⅴand the peak latency of wave Ⅰwere normal in 13 percent of 50 cases(100 ears) before surgery.The rate of missed diagnosis was 13%.Among 50 cases,41% had normal response threshold for wave Ⅴ,52% had slight abnormal responses of thresholds of wave Ⅴ and 7% had medium response threshold of wave Ⅴ.The peak latency of wavs Ⅰwas normal in 19% OME children,but it prolonged in 72% OME children and absent in 9% OME children.The prolonged peak latencies(waves Ⅰ,Ⅲ andⅤ) and eleveted response thresholds of wave Ⅴ and shorted transmission time between waves(Ⅰ-Ⅲ andⅠ-Ⅴ) significant when compared to the control group.After surgery,the response thresholds of wave Ⅴand the peak latency of wave Ⅰwere normal in 46.7% children,the response threshold of wave Ⅴ were normal in 70.5% and slight abnormal in 29.5%.Occuring(elicit) rate of wave Ⅰwas 100% and peak latency of wave Ⅰwas normal in 50.2% chilren.The differrence of peak latencies(waves Ⅰ,Ⅲ andⅤ) and the response threshold of wave Ⅴ before surgery

Objective To retrospectively assess the clinical manifestations and treatment of secondary syphilis with ocular impairment as the initial symptom. Methods Clinical data were retrospectively analyzed on secondary syphilis with ocular impairment as the initial symptom collected from September 1998 to October 2008. Results There were 11 syphilitic patients presenting acute ocular impairment as their initial manifestation. Skin eruptions developed simultaneously with ocular impairment in 2 patients, following ocular impairment in 9 patients. All patients were positive for rapid plasma reagent test (RPR) and treponema pallidum haemagglutination assay (TPHA), but negative for HIV. Of these patients, 9 suffered from uveitis (iridocyclitis, choroiditis or panuveitis), 2 from optic neuritis; 3 had unilateral ocular involvement, 8 had bilateral ocular involvement. After treatment with injected penicillin or ceftriaxone sodium, 9 patients experienced complete visual recovery, 2 partial visual recovery. Conclusions Ocular impairment occurs in patients with secondary syphilis at a low incidence, with no characteristic clinical manifestations. For patients who have no response to conventional ocular therapy, ocular syphilis should be considered and serological examination for syphilis is recommended.

Objective To explore the compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis.Methods Data of 296 patients with spinal tuberculosis from January 2000 to January 2011 were retrospectively analyzed.All patients were divided into two groups according to completeness of debridement:complete debridement group (group A) and incomplete debridement group (group B).There were 162 cases in group A including 86 males and 76 females,with an average age of 38.74± 17.26 years.There were 134 cases in group B including 73 males and 61 females,with an average age of 35.64± 18.21 years.All paticnts had undergone anterior debridement,focal graft implantation,anterior or posterior deformity correction,and internal fixation.Regular follow-up was required in the two groups.Results Residual sclerotic walls (36.54％),multipie cavities (34.62％),affected bony bridges (13.46％),sequestmm (3.37％),abscess (7.21％) and other lesionses (4.81％) were found in the group B.The first three factors were made up 84.62％ of the total.The mean follow-up time was 76.13±8.32 months in the group A and 79.24±5.49 months in the group B.The symptoms,C-reactive protein and erythrocyte sedimentation rate were improved more obviously in group A than those in group B.Six months after operation,tuberculosis healing rate in group A and group B was 29.01％ (47 patients) and 4.48％ (6 patients),respectively.The mean healing time was 4.36± 1.27 months in the group A and 9.15±2.53 months in the group B,with significant differences.The mean the time of chemotherapy was 5.21± 1.38 months in the group A and (10.45±2.15) months in the group B,with significant differences.Reoperation rate in group A and group B was 0.62％ (1/162) and 4.48％ (6/134),respectively.Conclusion Sclerotic bone,multiple cavities,and bony bridges are parts of foci in spinal tuberculosis.Clearing tuberculous foci with sclerotic bone,multiple cavities,and bony bridges can increase the curative effect,shorten the time of chemotherapy and reduce the side effects of drug,thus early resumption can be achieved.

Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is an autosomal recessive disease caused by SLC25A13 gene mutations, and is characterized by delayed jaundice clearance, liver dysfunction, and elevated aminoacidemia. The confirmed diagnosis depends on gene analysis. Citrin deficiency is one of the important causes of neonatal intrahepatic cholestasis in China. Recently more and more researches about NICCD were reported. The paper summarized the epidemiology, pathogenesis, clinical characteristics, and progresses in diagnosis and treatment of NICCD.

Objective To assess the clinical features of non-Hodgkin's lymphoma in cheek misdiagnosed as inflammatory myopathy.Methods Six patients presenting with unilateral swollen cheek were admitted at the Department of General Internal Medicine,Peking Union Medical College Hospital between January 2010 and December 2014.These patients were misdiagnosed as inflammatory myopathy and finally confirmed as Non-Hodgkin's lymphoma.The clinical characteristics,findings of laboratory tests and the diagnostic procedures were retrospectively analyzed.Results The median age of 6 patients (3 males and 3 females) was 30 years.The median duration from onset of unilateral swollen cheek to the final diagnosis was 13 months;the patients were referred to average 4 hospitals and experienced average 3 biopsies before admission.All patients had been treated with prednisone at a dose of 1 mg/kg or 0.5mg/kg per day.However,the symptoms relapsed in all patients after glucocorticoid tapering.No patient presented with proximal muscle weakness or myalgia.Two of 6 patients presented with unilateral forearm swollen.Creatine kinase was mildly elevated in 3 patients.Electromyographic abnormalities were seen in 4 patients.The biopsy showed muscle fiber necrosis,degeneration and a large amount of lymphocytes infiltration with or without vessel wall involvement.Erythrocyte sedimentation rate and high-sensitive C-reactive protein levels were normal.Anti-Jo-1,ANA and anti-U1RNP were all negative.EBV-DNV was significantly elevated in peripheral blood in 5 patients and it was positive in biopsy specimen in 3 patients.PET-CT scan was performed in 3 patients and suggested high metabolic activity with a SUV of 2.0-8.5 in cheek region.The biopsy specimen taken before admission did not show evidence of lymphoma.Repeated biopsies from cheek regions (3/6),lips (2/6) and forearm confirmed the final diagnosis as Non-Hodgkin's lymphoma,including 2 cases of T-cell lymphoma and 4 cases of NK/T cell lymphoma.Conclusion When patients present with unilateral swollen cheek without proximal skeletal muscle weakness or myalgia,even the pathologic evaluation implies inflammatory myopathy,non-Hodgkin's lymphoma should be considered.Repeated biopsy may be necessary to confirm the diagnosis.

Objective:To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. Method: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. Result:The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave Ⅰ,Ⅲ and Ⅴ latencies Ⅰ-Ⅲ ,Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals and postconceptional age. Wave Ⅰ and Ⅴ latencies, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals differed significantly between the two groups. Conclusion:The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

OBJECTIVE: To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. METHOD: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. RESULT: The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave I, III and V latencies I - III, III - V and I - V intervals and postconceptional age. Wave I and V latencies, I - III and III - V intervals differed significantly between the two groups. CONCLUSION The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.
Case-Control Studies ; Evoked Potentials, Auditory, Brain Stem ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; physiology ; Reflex, Acoustic

Objective:To investigate the effect of nonalcoholic fatty liver disease (NAFLD) on glucose and lipid metabolism during pregnancy.Methods:A retrospective analysis was performed in women who gave birth in Minhang Hospital Affiliated to Fudan University from January 2013 to June 2020. The data on demographic, clinical examination, and delivery were obtained via electronic medical record abstraction. According to the ultrasound imaging, all pregnant women were divided into NAFLD group and control group. The difference of glucose and lipid metabolism indexes, incidence of gestational diabetes mellitus, and gestational hypertension between two groups were compared. Logistic regression model was used to examine potential associations between NAFLD and metabolic related adverse pregnancy outcomes.Results:A total of 14 708 pregnant women with a mean age of (29.1±4.7) years and a mean body mass index of (21.0±2.8) kg/m 2 were included in our study. Of those eligible women, 554 (3.8%) were confirmed by ultrasound as NAFLD. Pregnant women with NAFLD presented higher circulating levels of fasting glucose [(4.2±0.5)mmol/L vs (4.1±0.5)mmol/L, P<0.01], 1 h plasma glucose [(7.4±1.7)mmol/L vs (6.6±1.6)mmol/L, P<0.01] and 2 h plasma glucose [(6.2±1.4)mmol/L vs (5.7±1.3)mmol/L, P<0.01] after glucose loading, HbA 1C [(5.2±0.4)% vs (5.1±0.5)%, P<0.01], triglyceride [(2.1±1.1)mmol/L vs (1.6±0.7)mmol/L, P<0.01], total cholesterol [(4.8±0.8)mmol/L vs (4.7±0.9)mmol/L, P<0.01], low density lipoprotein-cholesterol [(2.6±0.7)mmol/L vs (2.5±0.7)mmol/L, P<0.01], uric acid [(224.1±51.8)μmol/L vs (203.0±45.9)μmol/L, P<0.01] level. After adjusting for potential confounders, NAFLD significantly increased the risk of gestational diabetes mellitus ( OR=1.722, 95% CI 1.079-2.747, P=0.023) and gestational hypertension ( OR=3.845, 95% CI 2.247-6.582, P<0.001). Conclusions:Compared to non NAFLD, women with a diagnosis of NAFLD had more significant glucose and lipid metablic aberrations during pregnancy and increased incidence of gestational diabetes and gestational hypertension. Pregnant women with NAFLD should be closely monitored on glucose and lipid metabolism and blood pressure to prevent gestational diabetes mellitus and hypertension.

Objective To investigate the application value of magnetic-controlled capsule endoscopy (MCE) for gastric diseases in physical examination of asymptomatic population.Methods Data of 211 asymptomatic individuals who received MCE examinations from July 2015 to December 2016 in Changhai Hospital were collected and rctrospectively analyzed.The tolerance and safety of MCE were studied by analyzing the detection rate for the focal lesions and the rate of endoscopy transfer.Results Among 211 patients,the detection rate of the gastric focal lesions was 9.5％ (20/211).The detection rate in male was higher than that in female (P＜0.05).All patients completed MCE examination successfully and no adverse event was reported.Conclusion MCE,a non-invasive endoscopic modality,is safe and better tolerated than conventional endoscopy,and can be used as a promising approach to screening the gastric diseases in asymptomatic population due to high detection rate of these diseases.

PURPOSE: c-Met and its ligand, hepatocyte growth factor (HGF), play a critical role in oncogenesis and metastatic progression. The aim of this study was to identify inhibited enzymogram and to test the antitumor activity of SIM-89 (a c-Met receptor tyrosine kinase inhibitor) in non-small cell lung cancer. MATERIALS AND METHODS: Z′-LYTE kinase assay was employed to screen the kinase enzymogram, and mechanism of action (MOA) analysis was used to identify the inhibited kinases. Cell proliferation was then analyzed by CCK8 assay, and cell migration was determined by transwell assay. The gene expression and the phosphorylation of c-Met were examined by realtime-PCR and western blotting, respectively. Finally, the secretion of HGF was detected by ELISA assay. RESULTS: c-Met, activated protein kinase (AMPK), and tyrosine kinase A (TRKA) were inhibited by SIM-89 with the IC₅₀ values of 297 nmol/L, 1.31 µmol/L, and 150.2 nmol/L, respectively. SIM-89 exerted adenosine triphosphate (ATP) competitive inhibition on c-Met. Moreover, the expressions of STAT1, JAK1, and c-Met in H460 cells were decreased by SIM-89 treatment, and c-Met phosphorylation was suppressed in A549, H441, H1299, and B16F10 cells by the treatment. In addition, SIM-89 treatment significantly decreased the level of HGF, which accounted for the activation of c-Met receptor tyrosine kinase. Finally, we showed cell proliferation inhibition and cell migration suppression in H460 and H1299 cells after SIM-89 treatment. CONCLUSION: In conclusion, SIM-89 inhibits tumor cell proliferation, migration and HGF autocrine, suggesting it's potential antitumor activity.
Adenosine Triphosphate ; Blotting, Western ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Cell Movement ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Hepatocyte Growth Factor ; Lung Neoplasms ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Protein-Tyrosine Kinases