Cochlear Implantation ; methods ; Cochlear Implants ; Models, Anatomic

Background Diabetiretinopathy(DR) ione of the leading causeof blindness.To understand the risk factorof Dpathogenesiiimportanfothe prevention and treatmenof DR.Objective The purpose of thistudy wato survey the prevalence and relevanfactorof Damong diabetipatientaged ove45 yearold.Methodcross-sectional study wadesigned.physical examination waperformed on 7300 subjectfrom July,2010 to March,2011 athe FirsHospital of Shanxi Medical University,and 5012 of them received non-mydriatidigital funduphotography.Type 2 diabetimellituwadetermined in 574 subjects,and 480 casethaconformed to the criteriof the currenstudy were recruited.questionnaire survey wacarried ouin the 480 patients,and the prevalence of diabeteand Dwacalculated fothe analysiof the causative factorof DR.ResultGradable funduphotographwere available in 480 subjects,and 98 of them presented with Dcomplication aprevalence rate of 19.8％.The morbidity rateof Dwere 14.3％,19.4％,23.7％ and 21.5％ in the 45-55 yeargroup,＞55-65 yeargroup,＞65-75 yeargroup and ＞75 yeargroup,respectively,withousignificandifference among them (x2 =3.824,P=0.281).The incidence rateof Dwere 11.8％,13.2％,15.4％,27.0％ and 62.5％ in patientwith disease courseof lesthan 5 years,5-10 years,＞ 10-15 years,＞ 15-20 yearand ove20 years,respectively,with significandifference among differendisease duration(x2 =57.518,P =0.000).No significandifference waseen in the prevalence of Damong groupwith body weighindiceof ＜18.5,18.5-22.9,23.0-24.9 and ≥25.0 (16.7％,23.3％,16.8％,19.7％) (x2 =2.099,P =0.718) and differentreatmenmethod,such aoral antidiabetidrugs,insulin injection ocombination treatmen(18.8％,25.9％,19.8％,respectively) (x2 =1.477,P=0.478).The questionnaire survey showed close relevancy between gender,disease duration,fasting glucose concentration,family history of diabetes,and whethefunduexamination waperformed (P =0.025,0.000,0.001,0.003,0.039).ConclusionThe prevalence rate of Dwaassociated with the awarenesfodiabeteand treatmenmodes.Gender,disease duration,family history of diabetes,fasting glucose concentration and submission to eye examination are the independenrisk factorof DR.

Acupuncture Points ; Bloodletting ; instrumentation ; methods ; Humans

Objective To discuss clinical application of descending genicular artery perforator flap.Methods According to the anatomic features of direction,branches and anastomosis of the descending genicular artery,the descending genicular genicular artery perforator flap at medial superior aspect of knee joint was designed to reconstruct the soft tissue defects at the anterior medial 1/3 of the calf and the anterior medial part and popliteal fossa of the knee,with the axis based on the anterior border of the Sartorius and with the pivot point on the site where the cutaneous branches from the superior medial genicular artery pierced out within the triangle concave surface bounded by the vastus medialis,the tendon of adductor magnus and the condylus medialis.Results All flaps survived well in five patients,with primary healing.After a follow-up of 1-12 months,all flaps turned out to be with good texture,near-normal color and good appearance.Conclusion With a constant anatomic location,excellent blood supply and easy surgical procedure,the descending genicular artery perforator flap is one of feasible ways for repair of soft tissue defects around the knee.

Clinical practice teaching is the deepening and continuity of school education , which is an important part of medical education. This paper aims to analyze the current situation and problems as to the teaching management during clinical training of full-time clinical major students, and put forward the corresponding countermeasures . The clinical practice teaching management and the clinical intern training quality can be significantly improved by establishing normative practice teaching management sys-tem, innovating teaching management mechanism, and correct treatment of the contradiction between clin-ical practice, employment and taking part in the entrance exams for postgraduate schools.

Objective To study B lymphocyte subsets(na(?)ve B cells,memory B cells and plas- mablasts)of peripheral blood in patients with rheumatoid arthritis(RA)and its relationship with autoantibod- ies and clinical manifestation.Methods Blood samples and clinical data of 60 patients with RA were enrolled into this study.They were divided into three groups:active,inactive and refractory RA based on clinical mani- festations and 24 healthy controls were included.CD19 and CD27 of B cells in peripheral blood of RA patients and healthy controls were detected using flow cytometry at single-cell level.Frequence of na(?)ve B cells (CD19~+CD27~-),memory B cells(CD19~+CD27~(dim)),plasmablasts(CD19~+CD27~(high))and average fluorescence in- tensity of CD19 were analyzed,and their relationship with clinical manifestations and rheumatoid factor(RF), anti-typeⅡcollagen(anti-CⅡ),anti-cyclic citrullianted peptide(CCP)antibodies were investigatied.Results Frequence of na(?)ve B cells and plasmablasts in peripheral blood of patients with RA was increased compared with normal control.In contrast,memory B cells in patients with RA were decreased.The na(?)ve B cells subset in inactive and refractory RA was higher than that of healthy controls(P＜0.05),and the memory B cells subset in those groups was lower than that of healthy controls(P＜0.05).The plasmablasts in active and refractory groups of RA were higher than those of healthy controls(P＜0.05).The average fluorescence intensity of CD19 in peripheral blood in patients with RA was positively correlated with ESR,C-reactive protein(CRP),healthy assessment questionaire(HAQ),and plasmablasts was positively correlated with arthrocele index.Na(?)ve B cells,memory B cells and plasmablasts subsets had no relation with RF,anti-CⅡand anti-CCP antibodies. Conclusion B cell subsets in peripheral blood of patients with RA are significantly abnormal,characterized by expanded naive B cells and plasmablasts but diminished memory B cells.Plasmablasts are increasesd in active and refractory groups of RA,and have positive correlation with swollen joint index.B cells may play an important rote in the pathogenesis of RA.

Adenocarcinoma, Clear Cell ; complications ; metabolism ; pathology ; surgery ; Adenoma ; pathology ; Adnexal Diseases ; pathology ; Adult ; Carcinoma, Renal Cell ; pathology ; secondary ; Cystadenoma, Papillary ; complications ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Fallopian Tube Neoplasms ; complications ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; pathology ; secondary ; Mucin-1 ; metabolism ; von Hippel-Lindau Disease ; complications ; metabolism ; pathology ; surgery

Objective To investigate the inhibitory effects and mechanisms of a nature product derivate oridonin on in?vasion of human lung cancer. Methods Human lung cancer A549 and PC-9 cell lines were treated with oridonin. MTS as?say was used to determine cell proliferation. Transwell assay was used to determine the cell invasion, and adhesion assay to determine the cell adhesion. Flow cytometry was used to determine cell cycle. Western blotting and realtime-PCR were used to detect expression levels of CDK1, mTOR, p53, p21, E-cadherin, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src. The luciferase reporter assay was used to detect the NF-κB promoter activity. Results In vitro proliferation, invasion and adhesion of A549 and PC-9 cells were significantly inhibited by oridonin. The cell cycle was halted by G2/M phase, and ex?pressions of E-cadherin, p53 and p21 were promoted, while expressions of CDK1, mTOR, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src and promoter activity of NF-κB were down-regulated. Conclusion Oridonin is able to inhibit the in vitro invasion of human lung cancer A549 and PC-9 cell lines, which might be correlated with its abilities to regulate the ty?rosine kinase activity.

Objective To evaluate the relationship between carotid artery plagues and the clinical risk factors in patients with diabetes mellitus type 2 by observing the ultrasonic characteristics of carotid atherosclerosis plagues.Methods The ultrasound results of carotid arteries in 665 patients with diabetes mellitus type 2 from January 2009 to December 2011 in Beijing Amery General Hospital were retrospectively analyzed.The location and quantity of carotid atherosclerotic plaques were observed .The relationship between the occurrence and risk factors of diabetes such as hypertension ,family history of diabetes and age were analyzed.Single factor and multi-factor analysis were applied for the related risk factors .Results The ultrasonography showed 405 cases of carotid artery plaques.Most carotid artery plaques were located in the posterior wall of carotid sinus and were hyperechoic ,hypoechoic or isoechoic.The single factor analysis showed hypertension,family history of diabetes and age are risk factors of carotid atherosclerosis (χ2 =42.322,9.682 and 140.658,all P<0.01).Multi-factor logistic regression analysis showed age was an independent risk factor of carotid atherosclerosis in patients with diabetes mellitus type 2.The risk factors scores of patients who were less than 45 years,45-65 years and over 65 years of age were (3.50 ±1.16)scores,(3.46 ±0. 92)scores and (3.21 ±0.88)scores,and the difference was statistically significant (F=5.781,P<0.001). There were significant differences between risk factors scores of different age groups ( t =2.084,2.002, 3.786,3.474,2.877 and 2.504,all P<0.05).In patients more than 65 years of age,the risk of atherosclerosis plaques is 28.732 times higher than that of patients less than 45 years of age.After controlling the age factor,the possibility of atherosclerosis plaque increased 1.201 times for each additional one point of score. Conclusions Most carotid artery plaques in patients with diabetes mellitus type 2 are located in the posterior wall of carotid sinus and are hyperechoic ,hypoechoic or isoechoic.Age is an independent risk factor for the formation of carotid plaque.Patients more than 45 years of age should undergo early intervention to avoid the occurrence of major vascular complications .

Objective To explore the influence of feeding styles in early stage on children′s weight in different stages.Methods A complete record of 918 healthy infants was selected and then divided into 3 feeding groups:breast feeding, mixed feeding and artificial fee-ding, according to the way of feeding in the first 6 months after birth. Their weights and heights were measured in the 3rd,5th,8th,12th,18th,24th,60th month to conduct the Z score of weight for age (WAZ), weight for height (WHZ) and the body mass index (BMI) of 60-month-old infants.An investigation on the time of adding auxiliary food was conducted.Results The heavier,WAZ and WHZ of breast feeding group in the 3rd month were higher than the other groups,and the differences were statistially significant(F=4.12, 5.66, 5.79 Pa