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.

Objective To evaluate the local control effect of radiotherapy and intravesical chemotherapy following bladder preserving surgery for musculoinvasive bladder cancer. Methods Twenty three patients with muscle invasive bladder cancer were treated by bladder preserving surgery followed by external radiation ( mean dose 52.5 Gy) combined with intravesical mitomycin infusion after bladder preserving operation (study group).For comparison, 29 similar patients received the same treatment without radiation served as control (control group).Results All patients in the study group completed their designed treatment,except two patients whose protocol was interrupted for 3 days and one week due to acute cystitis. The mean follow up duration was 41.6 months. The 3 year local recurrence rates were 18.8% in the study group and 44.8% in the control group(P=0.026).The 3 year distant metastasis rates were 18.2% and 24.1% (P=0.437),and the 3 year overall survival rates were 81.8% and 86.2% (P=0.670),respectively. Conclusion It is demonstrated that adjuvant radiotherapy and intravesical infusion chemotherapy following organ preserving surgical procedure are encouraging by giving favorable local control for musculoinvasive bladder cancer.

OBJECTIVE To obtain primary knowledge of drug resistance to aztreonam(ATM) in commonly encounterd Gram-negative bacilli in our hospital thereby to bring the situation under control.METHODS A total of 3 928 strains of pathogenic bacteria were isolated from patients from 2001 to 2005,and drug resistance of these strains to ATM was examined.RESULTS Resistance of Pseudomonas aeruginosa,Klebsiella pneumoniae,Enterobacter cloacae and Acinetobacter spp to ATM was found to be tend increasing from 13%,14%,29% and 40% in 2001 to 28%,29%,40% and 77% in 2005.CONCLUSIONS The percentages of commonly encountered Gram-negative bacilli that are resistant to ATM have been considerably high and tend to increase further.ATM abuse needs to be given appropriate attention to.

This paper proposes algorithm in predicting the RNA secondary structure that combines several sequence comparisons, searches the eigenvalue for subsequence division with dynamic programing, utilizing the minimum free energy method. Moreover, the paper assesses the results derived from this new algorithm based on base-pairs distance, climbing distance and morphology distance. The paper also compares the assessment result and the prediction results of different prediction tools, and analyzes the advantages of the new method and its improvement direction.
Algorithms ; Nucleic Acid Conformation ; RNA ; chemistry

Objective To investigate the prognostic factors of gastrointestinal stromal tumors.Methods From Nov.1999 to Dec.2006,a total of 85 patients were diagnosed by postoperative pathology as gastrointestinal stromal tumors.The relationship between the prognosis of GIST and demographic factors、tumor location、operation style、preoperative metastasis、lymphadenectomy、grading of Fletcher were analyzed retrospectively.Results The 1 year、3 year and 5 year survival rate of these 85 patients were 94%,60%,57%respectively,Univariate analysis indicated that tumor location、operation style、grading of Fletcher and preoperative metastasis were significant predictors of survival(P<0.05),while demographics and lymphadenectomy were not statistically related with prognosis.Multivariate analysis showed that preoperative metastasis was the independent factor predicting the prognosis(P=0.020,β=4.226).Conclusion Radical surgical excision is still the therapy of choice for primary gastrointestinal stromal tumors.Preoperative metastasis is the independent factor predicting poor prognosis,therefore early diagnosis and treatment are very important for GIST.Fletcher grading is also a simple recalls to predict the prognosis of GIST.

Objective Brain metastasis(BM) is unusual in colorectal carcinoma(CRC) patients.This study was to evaluate the characteristics and prognosis of brain metastasis of colorectal carcinoma patients.Methods Twenty-eight consecutive CRC patients underwent surgical resection for BM between January 2001 and December 2008.The clinical data were analyzed by univariate (logrank) and Cox regression test.Results The median age at BM diagnosis from CRC was 57 years(41-75 years).Median survival after neurosurgical intervention was 9.4 months.The 1-year and 5-year survival rates were 28.9%and 7.1%,respectively.Seventeen patients(61%)had concurrent systemic metastasis.All patients were symptomatic with neurologic deficits and symptoms.On multivariate analysis,gender,infratentorial location of lesions and characteristics of primary CRC had no significant impact on survival.Two factors were signitlcandy associated with better survival:single brain metastases and absence of extracranial metastases.Perioperative mortality was zero.There were no difference of survival among patients undergoing resection alone and resection combined with whole brain radiotherapy (WBRT) or stereotactic radiosurgery(SRS). Conclusions Brain metastases from colorectal cancer is an evil omen of poor prognosis of CRC patients.Sursical resection of symptomatic brain metastases from colorectal cancer is relatively safe and provides the opportunity for prolonged survival.

Objective To investigate the expression of Foxp3+ Treg in liver cancer patients receiving liver transplant after immunosuppressive protocols FK506 or Rapamycin and evaluate the rejection prevention.Methods Liver transplant patients were randomly divided into FK506 group (10 cases),and Rapamycin group (10 cases).Real time quantitatve PCR was used to examine Foxp3 mRNA expression of patients' PBMC starting the 2nd month for consecutively 10 months.Foxp3 mRNA and incidences of acute rejection were compared between the two groups.Results Foxp3 mRNA expression was significantly lower in the FK506 group (0.1032 ±0.0943) as compared to that in the Rapamycin group (1.2136 ±0.6738)(t =5.1610,P ＜ 0.01) ;The incidences of acute rejection was significantly lower in the Rapamycin group as compared to that in the FK506 group after operation in the same period (x2 =2.2222,P ＜ 0.05).Conclusions FK506 may suppress the induction of immune tolerance after liver transplantation,while Rapamycin may play an important role in inducing and maintaining graft immune tolerance.Rapamycin is better than FK506 in preventing rejection reaction in liver cancer patients receiving liver transplant.

Object To study the expression of miRNA-146a in sepsis-induced acute lung injury (ALI) patients and its effect on the inflammation in mouse models.Methods miRNA-146a expression in peripheral blood was determined in sepsisinduced ALI patients and healthy volunteers by qRT-PCR.Sepsis-induced ALI mouse model were reproduced by LPS treatment and miRNA-146a mimic,miRNA-146a NC and miRNA-146a inhibitors were injected through trachea.The expressions of miRNA-146a,TNF-α,IL-1β and COX-2 mRNA were determined by qRT-PCR 24h after the intervention.Results The miRNA-146a expression in peripheral blood significantly increased in severe sepsis with ALI patients,compared with the control subjects.For mouse model,the expressions of TNF-o,IL-1β and COX-2 mRNA significantly decreased in miRNA-146a group,while increased in miRNA-146a inhibitor group compared with miRNA-146a NC group (P＜0.05).The TNF-α and IL-1β expressions significantly decreased in miRNA-146a inhibitor+COX-2 inhibitor group compared with miRNA-146a inhibitor group (P＜0.05).Conclusion MiR-146a treatment can effectively alleviate the lung inflammation in sepsis-induced ALI mice.

ObjectiveTo explore the correlation between the respiration-induced clinical target volume (CTV) motion and volume variation and the dosimetric variation of planning target volume (PTV) and organs at risk (OAR) during free-breathing (FB) with whole breast intensity-modulated radiotherapy (IMRT).MethodsSeventeen patients with breast conserving surgery underwent respiration-synchronized four-dimentional computed tomography (4DCT) simulation scans on the state of FB.The treatment plan was constructed using the end-inspiration phase scan,then copied and applied to the other respiratory phases.The dose distribution was calculated separately to evaluate the dose-volume histograms parameters for the PTV,ipsilateral lung and heart.ResultsDuring FB,the CTV motion vector was (2.09 ±0.74) mm,and the volume variation was (3.05 ± 0.94) ％.There was no correlation between the volume variation of CTV and dosimetric variation of PTV/OAR ( r =-0.390 -0.480,P =0.182 -0.775 ).In anteroposterior (AP),superoinferior (SI) and vector directions,the CTV movement correlated well with the PTV mean dose,conformal index,and the lung volume receiving high dose (V20,V30,V40,and V50;r=-0.975-0.791,P =0.000 -0.041 ).In SI and vector directions,the CTV displacement only correlated with the heart volume receiving ＞ 5 Gy ( V5 ) ( r =-0.795,0.687,P =0.006,0.028 ).The lung volume variation and the lung volume receiving high dose correlated reasonably well (r=0.655 -0.882,P=0.001-0.04 0).The heart volume variation only correlated with the V5 of heart (r =-0.701,P =0.024).ConclusionsDuring free-breathing,the effect of breast volume variation can be ignored for whole breast IMRT,and whole breast IMRT assisted with breath-hold may improve the accuracy of dose delivery during radiotherapy.

Objective To measure the displacement of the silver clips guided by kV-plain film at state of moderate deep inspiration hold(mDIBH) assisted by active breathing control(ABC) and to explore the margin of clinical target volume(CTV) to planning target volume(PTV) for breast cancer patients treated with three-dimensional conformal external-beam partial breast irradiation (EB-PBI) assisted by ABC. Methods The patients undertook CT simulation assisted by ABC to get the CT images on the respiratory condition of mDIBH. Four selected silver clips in breast cavity were delineated and the cavity based on all of the clips were delineated as gross tumor volume (GTV). Before each irradiation, two orthogonal kV-plain films were taken for the patients in the respiratory condition of mDIBH assisted by ABC device. 2D-2D auto-matie registration was performed based on pixel between the kV-plain films and the digital reconstructed radi-ographs(DRR). Then manual registration was undertook to get the shifts of the four clips separately at LAT, LNG,and VRT directions. Based on the shift data,the margins of CTV to PTV at LAT,LNG and VRT direc-tions were calculated. Results The margins from CTV to PTV were 5.00 mm,7.78 mm and 9.30 mm at LAT,LNG and VRT directions based on the clip at cephal border of the cavity. The corresponding margins were 4.40 mm,6.43 mm and 6.73 mm based on the clip at bottom of the cavity;5.04 mm,8.63 mm and 10.54 mm based on the clip at lateral border of the cavity;5.40 mm,8.59 ram and 10.81 mm based on the clip at pedal border of the cavity. Conclusions The silver clips in breast cavity can be clearly showed on the kV-plain film. The displacement of the clips can be exactly measured by registration of kV-plain film and planning DRR in condition of mDIBH assisted by ABC. The margins from CTV to PTV for EB-PBI can be calculated based on the displacement of the clips.