Objective To study sensorineural hearing loss classification and incidence of inner ear malformations based on the image of high-resolution computed tomography.Methods The investigation took the form of a retrospective review of CT findings relating to the 5 398 ears of outpatients in the general PLA hospital in the last 10 years.The inner ear malformations diagnosed by CT were classified according to the methods proposed by Sennaroglu's 2010.Results A total of 1 640 ears of inner ear malformations were found in 5 398 ears with sensorineural hearing loss by CT examination.The incidence of the inner ear malformation was 30.38% (1 640/5 398).The epidemiological information of 1 660 ears of inner ear malformation according to Sennaroglu's classification was as follows: cochlea information was 53.66%(880/1 640)and non-cochlea information was 46.34%(760/1 640)of the group.Eight hundred and eighty ears of cochlea malformation consisted of these types: 5 ear of Michel deformity, 23 cochlea of aplasia, 6 common cavity deformity, 69 cochlea of hypoplasia with 19 CH-I , 16 CH-II, and 34 CH-III, 777 cochlea incomplete partition with 44 IP-I , 703 IP-II and 30 IP-III.Seven hundred and sixty ears of non-cochlea malformation consisted of 680 large vestibular aqueducts, 80 simple vestibular/ semicircular canal/ internal auditory canal malformations.IP-II type and large vestibular aqueduct were related to the vestibular aqueduct malformation, making up 84.33%(1 383/1 640)ears of the whole malformation group.Conclusion The results suggest that 30.38% inner ear malformation can be found in ears with sensorineural hearing loss,higher than reported based on the image of high-resolution computed tomography.Sennaroglu's 2010 classifications have instructive significance in investigating the status of inner ear malformations.

Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. The paper reviewed the concept, construct, training model, measures and implementation in healthcare of team strategies and tools to enhance performance and patient safety (TeamSTEPPS) which was the most widely applied team training strategy, in order to provide reference for the healthcare in China.

Objective:To detect the expression and clinical significance of β-tubulin Ⅲ in cancer tissue of the patients with colon adenocarcinoma,and to explore its clinical significance.Methods:A total of 111 colon adenocarcinoma tissue samples were obtained.According to the location of β-tubulin Ⅲ positive cells, all patients were divided into front group (n=72) and non-front group (n=39).The positive expression rate of β-tubulin Ⅲ in the patients with colon adenocarcinoma was detected with immunohistochemistry.The correlations among the expression of β-tubulin Ⅲ and gender,age,tumor differentiation, clinical stage, lymph node metastasis, recurrence and death were analyzed.Results: The expression levels of β-tubulin Ⅲ had no significant differences between the patients with different gerder,age,lymph node metastasis,clinical stages,death and recurrence.The positive expression rates of β-tubulin in cancer tissue of the patients had significant difference between front and non-front groups (χ2=8.76, P=0.01).Lowly-to-moderately differentiated tissue was more common in front group, and highly-differentiated tissue was more common in non-front group(χ2=6.88, P=0.03).There were significant differences in the expression levels of β-tubulin Ⅲ between cancer tissues with different differentiation degrees (χ2=5.74, P=0.04).In non-front group, lymph node metastasis was closely correlated with the expression of β-tubulin Ⅲ (χ2=6.02,P=0.05).The results of immunohistochemical staining showed that the β-tubulin Ⅲ positive-expressing cells were colored brown-yellow.The number of cells with positive β-tubulin Ⅲ expression was significantly increased in highly differentiated tissue compared with low-differentiated tissue.Conclusion:The expression of β-tubulin Ⅲ is closely related to tumor differentiation in colon adenocarcinoma tissue.The highly differentiated colon adenocarcinoma tissue is more common in non-front group in which the expression of β-tubulin Ⅲ is related to lymph node metastasis.

Objective To investigate the sedative effects of different doses of dexmedetomidine with mid-azolam in spinal anesthesia. Methods 130 cases of spinal anesthesia were randomly divided into 2 groups,group D1 and group D2,with 65 cases in each group. Patients in 2 groups were given midazolam and dexmedetomidine with different doses. The heart rates ,blood pressure ,SpO2 ,Narcotrend value and Ramsay sedation scores were recorded at mutiple time points. The working time ,maintaining time of sedative effect ,and adverse reactions were compared between 2 groups. Results MAP,HR and NT decreased significantly in 2 groups(P < 0.05,respec-tively). The keeping time was relatively longer in group D1 compared with group D2(P<0.05). The working time was faster in group D2 compared with group D1. The rate of bradycardia in group D2 was relatively higher than that in group D1. Conclusion Good sedative effect can be obtained by drug in 2 groups. Group D1,with midazolam 0.05 mg/kg+dexmedetomidine 0.3μg/kg,may have a certain advantage in anaesthesia in the spinal canal.

Objective To investigate the clinical effect of a new type of disposable heparin freedialysis tube in uremic patients without heparin dialysis. Methods A total of 110 patients withoutheparin dialysis were divided into control group and observation group by random digits table method with55 cases each. Based on the same pre dialysis and dialysis for heparin saline flushing of discontinuoussaline on the control group using the traditional dialysis pipe for hemodialysis without heparin, theobservation group used disposable non heparin dialysis pipe for hemodialysis without heparin. The numberof patients with venous catheter blockage, blood loss and completion of dialysis time in two groups wasrecorded. Results The number of patients with venous catheter blockage, blood loss and completion ofdialysis time was 6, 6, 47 cases in control group and 0, 0, 54 cases in observation group. The differences were statistically significant (χ2=4.407, 4.407, 4.356, P<0.05). Conclusions The new disposableheparin free dialysis tube can reduce the loss of blood and prolong the treatment time, and the operation issimple, safe and effective, and has good application value and application prospect.

Objective: To discuss the significance of neoadjuvant chemotherapy followed by surgery in the treatment of local advanced esophageal cancer. Methods:A total of 272 cases of local advanced esophageal cancer were studied in retrospect. Out of the 272 cases, 112 were treated with neoadjuvant chemotherapy followed by surgery (CT-S), whereas the remaining 160 cases underwent surgical treatment (S) only. Complications and survival state after surgery were compared. Results: The rate of complications after surgery was as follows: CT-S: 34.8% (39/112); S: 29.4% (47/160), P=0.50. The five-year survival rate was 35.7% and 29.4%, respectively, P<0.05. The CT-S patients were divided into partial remission (PR) and stable disease (SD)/progressive disease (PD) groups according to the effect of the chemotherapy. The five-year survival rate was 38.5% and 30.1%, respectively, P<0.01. Conclusion: Neoadjuvant chemotherapy is available for local advanced esophageal cancer. Postoperative complications are not increased by chemotherapy, and the survival rate for local advanced esophageal cancer is improved by neoadjuvant chemotherapy. PR has better prognosis compared with SD/PD.

In our previous studies, DAZAP2 gene expression was down-regulated in untreated patients of multiple myeloma (MM). For better studying the structure and function of DAZAP2, a full-length cDNA was isolated from mononuclear cells of a normal human bone marrow, sequenced and deposited to Genbank (AY430097). This sequence has an identical ORF (open reading frame) as the NM_014764 from human testis and the D31767 from human cell line KG-1. Phylogenetic analysis and structure prediction reveal that DAZAP2 homologues are highly conserved throughout evolution and share a polyproline region and several potential SH2/SH3 binding sites. DAZAP2 occurs as a single-copy gene with a four-exon organization. We further noticed that the functional DAZAP2 gene is located on Chromosome 12 and its pseudogene gene is on Chromosome 2 with electronic location of human chromosome in Genbank, though no genetic abnormalities of MM have been reported on Chromosome 12. The ORF of human DAZAP2 encodes a 17-kDa protein, which is highly similar to mouse Prtb. The DAZAP2 protein is mainly localized in cytoplasm with a discrete pattern of punctuated distribution. DAZAP2 may associate with carcinogenesis of MM and participate in yet-to-be identified signaling pathways to regulate proliferation and differentiation of plasma cells.
Amino Acid Sequence ; Base Sequence ; Chromosomes, Human, Pair 12 ; genetics ; Chromosomes, Human, Pair 2 ; genetics ; Cytoplasm ; metabolism ; DNA Primers ; DNA, Complementary ; genetics ; Down-Regulation ; Gene Components ; Humans ; Likelihood Functions ; Models, Genetic ; Molecular Sequence Data ; Multiple Myeloma ; genetics ; metabolism ; Phylogeny ; Pseudogenes ; genetics ; RNA-Binding Proteins ; genetics ; metabolism ; Sequence Alignment ; Sequence Analysis, DNA

Objective:To explore the necessity of the preventive use of antibiotics and the effects of age and operation time on the efficacy of inguinal hernia repair without tension,and to elucidate the clinical significance of the preventive application of prophylactic antibiotics in inguinal hernia repair without tension.Methods:A total of 228 patients with inguinal hernia repair without tension were selected,amomg them 42 cases with high infection factors were treated with antibiotics (treated group),and 186 cases were not treated with antibiotics(untreated group) during the preoperative period.The prophylactic antibiotics were given 30 min before surgery,and the conventional dose was not used more than 48 h after surgery.All the cases were treated with artificial repair materials for the procedure of inguinal hernial repair without tension.The age,highest body temperature,white blood cell count,operation time,hospitalization time,and postoperative body temperature of all the 228 cases were recorded and analyzed statistically.Results:The preoperative and postoperative white blood cell counts had significant differences between the patients<60 years and the patients≥60 years in untreated group (P<0.05);there were no significant differences in the operation time,hospitalization time and body temperature between the patients<60 years and the patients≥60 years in untreated group (P>0.05).Compared with the patients with the operation time>90 min,the white blood cell count and hospitalization time of the patients with the operation time ≤90 min were increased (P<0.05).There were no significant differences of the body temperature and age between the patients with the operation time >90 min and the patients with the operation time≤90 min (P>0.05).The white blood cell count,operation time,hospitalization time and postoperative body temperature of the patients between treated group and untreated group had no significant differences (P>0.05).Conclusion:The use of antibiotics in the high-risk patients and non-use of antibiotics in the majority of elective inguinal hernia repair without tension can ensure the safe and performability of the patients.

Objective To design and investigate the clinical effects of parallel double venous pots hemodialysis tubing set in patients with heparin-free hemodialysis.Methods Totally 120 patients who received hemodialysis therapy in our hospital from May,2014 to June,2016 were randomly divided into the experimental group (n=60) and the control group(n=60) via random number table.The experimental group received self-designed parallel double venous pots dialysis tubing set,while the control group received the normal dialysis tubing set.The number of preventive replacement of dialyzer and tubing set during heparin-free dialysis,the number of discarded tubing set due to coagulation and the time frame for the first tubing set were recoded from two groups.Results There were statistically significant differences in the number of discarded tubing set due to coagulation and the time frame for the first tubing between two groups(P＜0.05).Conclusion Parallel double venous pots dialysis tubing set can reduce the number of discarded tubing set due to coagulation,prolong the time frame for the first tubing.

A 26?year?old male patient presented with facial depigmented patches for 10 years, some of which turned to blue?grey 7 years prior to the presentation. Before the white patches turned blue?gray, the patient developed contact dermatitis due to topical application of self?made drugs. Skin examination showed blue?gray hyperpigmentation on the left upper lip and in the temporal region, with white hairs in the hyperpigmented lesions on the left upper lip. Dermoscopy revealed irregularly shaped, light to dark blue?gray patches on the left upper lip, which were intermingled with white patches in some regions, and white hair stubs were observed in the white patches. Histopathological examination of temporal lesions showed decreased melanocytes in some regions in the epidermis, pigmentation in both basal and suprabasal layers, perivascular infiltration of a small number of chronic inflammatory cells and melanophages in the superficial dermis, and melanophage infiltration around sweat ducts. Finally, the patient was diagnosed with blue vitiligo. He refused to receive any treatments, and follow?up was under way.