For the purpose of studying the diagnostic significance of the traumatic perforation of the tympanic membrane by the otologic endoscopy and video tape recording, one hundred and fourteen patients 117 ears, with ear drum injury caused by the head and facial trauma were examined and analyzed by using the Hopkin modle mult angle otologic endoscopy and the video tape recorder. The results showed that the traumatic perforation of te tympanic membrane were found in all four quadrants of the membrane,61 91% of the perforation located in the anteriorinferior quadrant,of the tense part of the membrane. The shapes of the perforation were spindle,triangular,slit, irregular and lune. The nontraumatic perforation of the tympanic membrane often located in the center or the margin of the membrane and were round or oval in shape. The otologic endoscopy and video tape recording can display the morphologic features of the traumatic and nontraumatic perforations of the tympanic membrane objectively and provide reliable diagnostic and investitgative method for the forensic practice.

Objective To understand the clinical effect of conservative lapamscopic surgery with stripping corpus luteum for fallopian pregnancy to prevent persistent ectopic pregnancy.Methods From January 2005 to Augnst 2008.82 cases of fallopian pregnancy (6 cases for the second time) were performed conservative operatio through laparoscopic surgery with stripping corpus luteum.Seventy one cases underwent salpingostomy to remove the embryo, and other 11 cases were performed with extrusion of embryo sac at ampulla.The level of serum progesterone,β-HCG were measured before and after the therapy.All patients were followed up for one year.Results All patients'surgery had been successfully done through laparoscopie surgery.The duration of stripping corpus luteum was 5 to 10 minutes.The serum β-HCG(Mean±SD:(1213.51±118.84)U/L)and progesterone(Mean±SD:(3.25±2.44)nmol/L)arer operation were significantly lower than before the therapy(Mean±SD:(4267.86±983-56)U/L.(13.71±6.24)nmol/L,respectively)(P<0.01).The decrease of β-HCG value wag significantly correlated with the decreasing of progesterone(r=0.697,P<0.05).Only one patient had a persistent ectopic pregnancy.Fallopian examination through hysterosalpingography after 3 months was unobstructed in 71.1%(32/45 cases)and oh-strueted in 7 cases(15.6%).After one year ofthetherapytwo patients hadectopic pregnancy atthe same fallopian tube.Conclusions For females who have reproductive requirements with experience of fallopian pregnancy,conservative operation through laparoscopic surgery with stripping corpus luteum is safe and effective,and might have an important clinical effect to prevent postoperative persistent ectopic pregnancy.

Objective To study the clinical findings and audiological characteristics of auditory neuropathy. Methods Clinical findings, pure tone threshold, acoustic impedance audiometry, speech audiometry, auditory brainstem response (ABR) and distortion product otoacoustic emission( DPOAE) were analyzed in 23 cases of auditory neuropathy. Results The patients were predominantly youngster, female more than male. Pure tone audiometry revealed mainly binaural symmetric upward - sloping audiogram with mild and moderate hearing loss at low frequencies. Speech discrimination score was obviously reduced, which was disproportionately to the pure tone threshold. Ipsilateral and contralateral stapedial reflex were absent. ABR was severely abnor- mal. DPOAIE was normal or nearly normal. Conclusion Clinical findings and systemic audiometry revealed the main characteristics of auditory neuropathy, which could be used not only for the understanding, but also for the diagnosis of this disease.

Objective To explore the characte ristics of pure tone threshold (PTT) in auditory neuropathy. Methods The results of PTT audiometry were analysed in 48 patients with auditory neuropathy and compared with that of cochlear deafness. Results PTT audiograms in auditory neuropathy group r evealed curves including ascending slope, peak, spoon, letter W, lain letter S, flat, gentle slope. Binaural symmetric PTT audiograms were seen in 38 cases and asymmetric in 10 cases. The auditory threshold in auditory neuropathy showed a e levated range from mild to moderate degrees. Elevated degrees of auditory thresh old in left and right ears were consistent. The elevations of low-frequency audi tory threshold or in the main feature of low-frequency auditory threshold were 9 3.75% (90/96 ears) in the PTT audiograms. Conclusion The elevations of biauricular symmetric and ba sic symmetric low-frequency auditory threshold or in the main feature of low-fre quency auditory threshold were important characteristics of auditory neuropathy.

AIM: To explore the effect and mechanism of preoperative transarterial chemoembolization on nephroblastoma.METHODS: Comparative analysis of clinical and pathological features in 39 children with Wilms’ tumor was conducted. TUNEL assay was used to detect the apoptosis of tumor in two groups with or without preoperative interventional treatment. The expressions of P53, Bcl-2 and Bax proteins were detected by immunochemical methods. The patients were followed-up for more than 2 years.RESULTS: The extent of neoplastic cell necrosis and degeneration, interstital fiber tissue hyperplasia of tumor and the number of infiltrating lymphocytes were observed, which were higher in interventional group than those in simple excision group (P

Objective To investigate the effect of Dl-3-n-butylphthalide on acute cerebral infarction.Methods In Department of Neurology in the Fifth Hospital of Wuhan from March 2013 to June 2014,100 cases of patients with first onset of acute cerebral infarction were recruited.The participants were divided into 2 groups (control group and treatment group) randomly,with 50 participants in each group.Besides general treatment,the patients of treatment group received intravenous injection of Dl-3-n-butylphthalide in acute phase and orally took soft capsule of Dl-3-n-butylphthalide in recovery phase.All the patients were followed up for 24 weeks.Neurological function and general cognition were assessed separately by national institute of health stroke scale (NIHSS),and mini mental state examination (MMSE) was applied to assess overall cognitive function.Results NHISS score was gradually decreased and MMSE score was increased in both groups.As compared with the control group,NIHSS score and MMSE score were changed significantly in the treatment group.From first onset to 24 weeks after treatment,NHISS score was decreased by 30％ in the control group and 44％ in the treatment group;MMSE score was increased by 17％ in the control group and 32％ in the treatment group.Conclusion Sequential therapy with Dl-3-n-butylphthalide improves neurological function and general cognition faster and more significant for patients with acute cerebral infarction.

BACKGROUND:The existed artificial anal sphincter cannot sense whether there are intestinal contents in the bowel and the state of intestinal contents, and the previous studies on the intestinal content signal did not included the different parts of colon and the signals of different intestinal content status.
OBJECTIVE:To compare the differences of ultrasound signals of different intestinal content status in different parts of New Zealand rabbits detected with transmission-type ultrasonic signal detection system.
METHODS:Twenty healthy New Zealand rabbits were used;the rabbits were divided into groups according to distal part of proximal colon, distal colon and distal rectum. Five positions of solid stool particles were selected randomly as the detection point in each group. The voltage signals of stool were measured under solid, fluid, gaseous, and deflation status of the lumen.
RESULTS AND CONCLUSION:In rectum, there were no significant differences in voltage signals between solid and gaseous conditions, while there were significant differences between fluid and deflation conditions (P=0.000). Multiple comparison showed there were significant differences between four conditions in distal part of proximal colon and distal colon (P=0). There were significant differences in voltage singles between rectum, distal colon and proximal colon under solid and fluid conditions (P=0). Multiple comparison showed there were significant differences in any part of large bowel for solid and fluid status (P=0). There were no significant differences in voltage singles between rectum, distal colon and proximal colon under gaseous and deflation conditions. There was interactive effect of intestinal contents between three parts of large bowel under the four conditions (P=0.000). Transmission-type ultrasonic detection system can distinguish artificial intestinal contents sensory nerves of various intestinal contents. And the application of ultrasonic detection system to detect the intestinal contents under different conditions can provide a new effective method for the research on artificial intestinal content sensory nerves.

Objective To explore the value of glypican-3(GPC-3)mRNA and paternally expressed 10(PEG10)mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma(HCC). Methods With SYBR Green I as fluorescence signal,real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis(n=8),HCC without metastasis(n=12)and hepatic cirrhosis(n=11),and receiver operator characteristics curve(ROC)and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis(P<0.05),while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis.In single test,the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7%for GPC-3 mRNA and 72.2%for PEG10 mRNA,and the specificities were 91.7%and 91.7%.respectively.The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA.With two markers in parallel test,the sensitivity,specificity,negative likelihood and diagnostic accuracy were 90.7%,84.O%,0.11 and 83.3%,respectively.In serial test,the sensitivity,specificity,positive likelihood and diagnostic accuracy were 60.5%,98.7%,45.5 and 73.3%,respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC,and PEG10 mRNA works better than GPC-3 mRNA.The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.

AIM: By studying the ultrastructure of organs (hearts, brains, lungs, livers, kidneys) and vascular endothelial cells, and changes of physiological and biochemical indexes with multiple organ dysfunction syndrome in the elderly rats, their signification and their developing rules were analyzed. METHODS: Wistar rats(Half of Wister rats were three-month-old and another half of twenty-month-old) were anaesthetized and dealt with cecal ligation puncture (CLP) operation. They were defined as MODSE group and MODSY group, respectively. They were perfused through all vascular circulation by 1% glutaric dialdehyde. These slices were observed under transmission electron microscopy. RESULTS: Physiological and biochemical indexes at 24 huor in elder rats were shown significant difference compared with the younger rats ( P

Objective To systematically evaluate the short-term outcomes of Da Vinci robotic surgical system and laparoscopy in pancreaticoduodenectomy.Methods Literatures were researched using PubMed,Embase,Medline,VIP database,Chinese Journal Fulltext Database from January,2013 to October,2016 with the key words including laparoscopic,robotic,Da Vinci,pancreaticoduodenectomy,腹腔锐,达芬奇机器人,胰十二指肠切除术”.The cohort studies about comparison of short-term outcomes of Da Vinci robotic surgical system and laparoscopy in pancreaticoduodenectomy were received and enrolled.Patients undergoing pancreaticoduodenectomy using Da Vinci robotic surgical system and laparoscopy were respectively allocated into the Da Vinci group and laparoscopy group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as odd ratio (OR) and 95％ confidence interval (CI).Measurement data were represented as weighted mean difference (WMD) and 95％CI.The heterogeneity of the studies was analyzed using the I2 test.Results Five retrospective cohort studies were enrolled in the Meta analysis,and the total sample size was 364 patients,including 159 in the Da Vinci group and 205 in the laparoscopy group.The results of Meta analysis showed that there were statistically significant differences in the rate,of conversion to open surgery,spleen-preserving rate,operation time and duration of postoperative hospital stay between Da Vinci group and laparoscopy group (OR=0.18,3.80,WMD =-37.54,-4.47,95％CI:0.05-0.60,2.01-7.18,-47.46--27.62,-6.70--2.24,P＜0.05).There were no statistically significant difference in the incidence of pancreatic fistula and overall incidence of complications between Da Vinci group and laparoscopy group (OR=0.95,0.55,95％CI:0.59-1.54,0.29-1.03,P＞0.05).Conclusions Da Vinci robotic surgical system and laparoscopy are safe and feasible in pancreaticoduodenectomy,with the same incidence of postoperative complications.Compared with laparoscopy,Da Vinci robotic surgical system can not only reduce the rate of conversion to open surgery,operation time and duration of postoperative hospital stay,but also increase spleen-preserving rate,meanwhile,it does not increase the incidence of postoperative complications.