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.

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 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 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.

Acupuncture Points ; Bloodletting ; instrumentation ; methods ; Humans

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

Chronic prostatitis is a common male disease, and its pathogenesis is not yet clear. Most scholars believe that oxidative stress and immune imbalance are the keys to the occurrence and progression of chronic prostatitis. Currently immunotherapy of chronic prostatitis remains in the exploratory stage. This article relates the active ingredients of 5 Chinese medicinal herbs (total glucosides of paeony, tripterigium wilfordii polglycosidium, curcumin, geniposide, and quercetin) for the treatment of chronic prostatitis and their possible action mechanisms as follows: 1) inhibiting the immune response and activation and proliferation of T-cells, and adjusting the proportion of Th1/Th2 cells; 2) upregulating the expression of Treg and enhancing the patient's tolerability; 3) suppressing the activation of the NF-kB factor, reducing the release of iNOS, and further decreasing the release of NO, IL-2 and other inflammatory cytokines, which contribute to the suppression of the immune response; 4) inhibiting the production of such chemokines as MCP-1 and MIP-1α in order to reduce their induction of inflammatory response. Studies on the immune mechanisms of Chinese medicinal herbs in the treatment of chronic prostatitis are clinically valuable for the development of new drugs for this disease.
Chemokines ; immunology ; Cytokines ; immunology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Immune System ; drug effects ; Male ; NF-kappa B p50 Subunit ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Plants, Medicinal ; Prostatitis ; drug therapy ; immunology ; T-Lymphocytes, Regulatory ; drug effects ; Th1-Th2 Balance

Background Compare with the lamellar laser refractive surgery,the laser slip on the surface operation is a better method in the correct of refractive error without the flap-related complications.However,whether to remain corneal epithelial flap and its influence for epithelial healing and visual restoration are still under investigation.Objective The aim of this study was to compare the short-term clinical efficacy of epipolis laser insitu keratomileusis (Epi-LASIK) and flap-free Epi-LASIK for correction of refractive error in high myopia.Methods The paired control design was adopted.Sixty eyes of consecutive 30 patients with high myopia were collected in this study.The written consent form was obtained from each patients prior to operation.Regular EpiLASIK was performed in the right eyes and the flap-free Epi-LASIK was carried out in the left eyes.Patients were followed-up for one month.The postoperative ocular irritation symptoms were scored,and the healing period of corneal epithelium and uncorrected visual acuity were examined at 1,3 and 5 days after operation.The naked visual acuity,diopter,best corrected visual acuity and the grading of haze were recorded and compared between the two groups at one month after operation.Results After surgery,the scores of corneal irritation were 3.13 ±0.43 and 3.30±0.47on the first day,showing insignificant differences between these two groups (t =- 1.54,P＞0.05 ).However,there existed statistically significant difference in the scores of corneal irritation on the third day after operation between the two groups (t =- 17.95,P＜0.01 ).The average time of corneal epithelial healing were (2.58 ±0.49 ) days in the flapfree Epi-LASIK group and ( 3.98 ±0.74) days in Epi-LASIK group with the significant difference between them (t=-11.36,P＜0.01 ).There was no statistical difference in uncorrected visual acuity in the first day (0.59±0.12 vs 0.58±0.11,t=0.39,P＞0.05),the fifth day (0.69±0.08 vs 0.67±0.09,t=0.84,P＞0.05) and 1 month (t =-1.90,P＞0.05 ).No significant difference was seen in the diopter between the two groups in 1 month after surgery (-1.03±0.45 vs -1.07 ±0.38,t =-0.31,P＞0.05 ).The eye numbers of corneal haze for 0 grade were 27 ( 90.00％ ) and over the 0.5 grade were 3 ( 10.00％ ) in flap-free Epi-LASIK group respectively,and those of corneal haze for 0 grade were 26(86.66％ ) and above the 0.5 grade were 4 (13.33％) in Epi-LASIK group respectively,showing a considerably difference between the two groups (x2 =0.0031,P＞0.05).Conclusions Both the flapfree or reserved epithelial Epi-LASIK allow the safe and effective correction of refractive error in high myopia,showing good predictability and stability in short term.Flap-free Epi-LASIK can relieve the corneal irritation symptom and accelerate the healing of corneal epithelium and recovery of visual acuity.

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 .