OBJECTIVE:To compare the healing effect of traditional therapy versus the traditional therapy in combination with additional externally applied agent on the traumatic tympanic membrane perforation with a focus on the effect of recombinant human epidermal growth factor(rhEGF) in promoting healing of tympanic membrane perforation.METHODS:A total of 90 patients with traumatic tympanic membrane perforation were randomly divided into two groups:one group received traditional therapy in which the anti-inflammatory drug was given plus nasal administration with water not allowed entering in the external acoustic meatus;another group was treated with traditional therapy plus rhEGF cotton applied externally.The healing of the tympanic membrane perforation and the auditory acuity improvement in two groups were monitored.RESULTS:In rhEGF group(58 cases),the cure rate reached 100%,with an average healing time of 5.3 days;Of the 32 cases in the traditional therapy group,7 were not failed,and 25(78%) healed,with an average healing time of 28.4 days.The healing time of tympanic membrane perforation in rhEGF group was significantly shorter than in traditional group,showing significant difference(P

Objective To investigate the relation of the MR manifestations and the pathological characteristics of dissociated discherniation.Methods Characteristics of pathology and MRI of 23 cases of dissociated disc herniation were retrospectively analysed.Results Of 23 cases,the dissociated disc was low signal intensity(compared with spinal cord) on T_1WI and T_2WI with distinct margine in 7 cases,the adhere and inflammation were slight on pathology;iso-or hypo-signal intensity on T_1WI,low signal intensity in the center and slight high signal intensity at periphery on T_2WI with an distinct margine in 13 cases,while the adhere and inflammation were obvious on pathology;on T_1WI slight high signal intensity on T_1WI and iso-intensity on T_2WI in 3 cases,and fibroplasia was showed on patholgy.In the 12 cases with enhanced MRI,the lesions were slight enhancement at periphery and enhancement in the center in 7 cases,no enhancement in 3 cases,slight enhancement in 2 cases.Conclusion MRI signal characteristic can reflect pathologic changes expressly of the dissociated disc herniation.

Objective To investigate the value of arthroscope in the diagnosis and treatment of knee synovitis. Methods 50 cases of knee synovitis diagnosed by arthroscopy and treated by endoscopic synovectomy were studied. There were 10 cases with rheumatoid arthritis, 11 cases with pigmented villonodular synovitis,5 cases with chronic infection of knee joint,12 cases with chronic non-specific synovitis,5 ca-ses with tuberculous synovitis of the knee,4 cases with meniscus injury,3 cases with unknown cause. The efficacy of the treatment was recor-ded. Results All these cases were clearly diagnosed by microscopic examination combined with synovial pathological examination,and 10 cases were corrected with clinical diagnosis post-operation. All cases received primary healing without serious complications. All cases were followed up,and 6 cases of pigmented villonodular synovitis,2 cases of rheumatoid arthritis,1 case of chronic non-specific synovitis and 1 case of tuberculous synovitis of the knee had recurred. The total effective rate was 80. 0%. Conclusion The application of arthroscopy and syno-vial biopsy was effective in diagnosis. Arthroscopic synovectomy had good effect on treatment with less trauma and complications.

The chemic al composition of traditional Chinese medicine (TCM) is the material base for its prevention and treatment of disease. Characterization, analysis and isolation of chemical constituents, important fields of modern research on TCM, however, are still a great challenge due to the complexity. In recent years, considerable progress has been made in these fields with the application of new chromatographic packing materials and methods, analysis technologies represented by LC-MS and the associated databases and softwares. Here, the advancement of methods and strategies used in the research on the chemical constituents of TCM is briefly reviewed.

Objective To study on the CDKN2/P16 gene in primary osteosarcoma.Method By using molecular biological methods that inclued genome DNA extraction from paraffined tissue and PCR SSCP analysis technique, we studied alternations of CDKN2/P16 gene in 25 primary osteosarcomas.Results (1)The deletions frequency in differentiation degree of osteosarcomas was① bone brood cell, 16.7% ;② cartilage brood cell,12.5% ;③ Fiber brood cell:20% ,(P >0.05).(2)The deletion frequency in male patients was 17.6% , female patients 12.5% ,(P >0.05).(3)In early metastatic osteosarcomas the deletion rate was 33.3% ,which was significantly higher than that of the control group with the rate of 10.5% (P< 0.05).(4)The deletion rate was 16% and the mutations were not found.Conclusion (1)The deletion rate was 16% and the mutations were not found.This suggests that the deletions of CDKN2/P16 gene were closely related to the genesis of primary osteosarcoma and that the main type of the alternation of CDKN2/P16 gene was deletion.(2)In early metastatic osteosaarcomas the deletion rate was 33.3% , which was significantly higher than that of the control group with the rate of 10.5% .This indicates to great extend that the deletions of CDKN2/P16 gene were closely related to the metastatic ability.(3)The deletions frequency had no significant relationship with differentiation degree of osteosarcomas, so was with the sex of the patient.

Objective To explore the level of polyunsaturated fatty acids (PUFAs) in blood plasma and its relation with the behavior ofchildren with autism. Methods High performance liquid chromatography was used to measure the level of free PUFAs of blood plasma in30 autistic children and 20 healthy children. Conner's Parent Rating Scale (parents) and the Repetitive Behavior Scale-Revised (RBS-R) RatingScale were used to evaluate the behavior of the children, and the relationship between the PUFAs level and abnormal behavior in the childrenwas also analyzed. Results The level of α-linolenic acid (ALA), docosahexenoic acid (DHA) and total n-3 PUFAs were lower in autisticchildren than in healthy children (P<0.05), especially lower in DHA (P<0.01). There was no significant difference in n-3 PUFAs betweentwo groups (P>0.05); There were negatively correlations between the level of DHA and total n-3 PUFAs in blood plasma and impulsion-hyperactivity,hyperactivity index, learning, anxiety, stereotypic behavior, self-injurious behavior, compulsions, ritualistic behavior and samenessbehavior. Conclusion The level of n-3 PUFAs in blood plasma of autistic children was lower than the healthy children and the level ofPUFAs were correlated with the behavior of autistic children.

Objective To investigate the correlation between FA value,ADC value and limb muscle strength score measured by magnetic resonance imaging in patients with ischemic stroke,aims to to analyze the clinical value of magnetic resonance imaging in limb muscle strength.Methods Twenty patients with acute cerebral infarction and treated from June 2015 to Junly 2016 were recruited from This hospital,and the simplified Fugl-Meyer motor function score was observed for all patients within 3 days.Tensor imaging examination was conducted to observe the distribution of nerve fiber bundles,FA value,ADC value changes.Results The FA value and ADC value of the infarct side were significantly different from those of the contralateral side(t=8.70,t=-18.70,P＜0.05);There were significant differences in FA value and ADC value between the infarcted ventricle hind limbs and the contralateral side of the infarcted ventricle(t=-5.16,t=-5.08,P＜0.05).The FA value of the infarcted ventral hind limbs had positive correlation with the simplified Fugl-Meyer motor function score(R=0.863,P=0.013).Conclusion FA value and ADC value of acute infarct and internal hindlimb are lower than FA value and ADC value of contralateral normal white matter.The FA value of internal capsule hind limbs is closely related to the simplified Fugl-Meyer motor function score.

Objective To prospectively analyze the impact of frailty on the short-term outcomes of coronary heart disease (CHD) and its related factors.Methods A total of 505 patients aged ≥65 years,with diagnosis of CHD in Cardiology Department and Geriatrics Department in our hospital were selected.Clinical data including geriatrics syndromes were collected by using Comprehensive Geriatrics Assessment (CGA).Frailty was defined according to the Clinical Frailty Scale (CFS).The impact of the comorbid conditions on the risk was quantified by the coronary artery disease-specific index.Patients were followed up by clinic visit or telephone consultation.Following-up items included recurrence of all-cause mortality,recurrence of cardiovascular events,and unscheduled returned visit.The impact of frailty on the prognosis of coronary heart disease was analyzed by Cox regression.Results Of the 505 patients,221 patients (43.76％) were considered to be frail elderly,in whom 126 patients (24.95％) were assessed as moderately to severely frail elderly.The incidences of comorbidities and geriatrics syndrome including incontinence,fall history,visual impairment,hearing impairment,constipation,chronic pain,sleeping disorder,dental problems,anxiety or depression,and delirium were higher in frail patients than in non-frail patients[51.1％ (113/221) vs.30.6％ (87/ 284),31.2％ (69/221) vs.19.0％ (54/284),43.9％ (97/221) vs.29.9％ (85/284),49.3％ (109/221) vs.29.6％ (84/284),60.2％ (133/221) vs.33.8％ (96/284),62.0％ (137/221) vs.46.8％ (133/284),49.3％ (109/221) vs.37.7％ (107/284),79.2％ (175/221) vs.55.6％ (158/284),11.3％ (25/221) vs.6.0％ (17/284),2.7％ (6/221) vs.0 (0/284),x2=21.831,10.053,10.510,20.519,34.894,11.481,6.886,30.695,4.624,7.803,respectively,all P＜0.05].After adjusting for sex,age,severity of illness and other coexist factors,the Cox survival analysis showed that frailty was the independent risk predictor for the all-cause mortality and unscheduled return visit in CHD patients (HR=2.881 and 1.835,95％CI:1.591-5.215 and 1.458-2.311,both P＜0.001).Conclusions Comprehensive Geriatrics Assessment and Clinical Frail Scale are useful to evaluate the clinical features in elderly CHD patients.Frailty is the independent risk predictor for the short-term prognosis including all-cause mortality and unscheduled return visit in elderly CHD patients.

Objective To investigate the variability in biochemistry in cerebral palsy children who accepted rehabilitation exercise. Methods From March to November, 2015, 24 children with cerebral palsy were measured the levels of hemoglobin, creatine kinase and blood urea before treatment. They all accepted routine rehabilitation exercise, and were measured hemoglobin, creatine kinase and blood urea again one week after treatment as the load increased, and six weeks after treatment at the end of exercise. They were assessed with Gross Motor Function Measure (GMFM-88) before and six weeks after treatment. Results The scores of GMFM-88 improved after treat-ment (t>7.12, P<0.001). Hemoglobin decreased (P<0.01), while creatine kinase and blood urea increased one week after treatment (P<0.01). Hemoglobin and blood urea came back to the levels before treatment six weeks after treatment (P?0.05), while creatine kinase reduced (P<0.01), but was still more than that before treatment (P<0.01). Conclusion Hemoglobin, creatine kinase and blood urea may respond the train-ing situation of cycle and the stage of exercise, and indicate the effects of load in the cerebral palsy children accepted rehabilitation exercise.

Pang Zanxiang was a famous ophthalmologist of Chinese medicine. Based on his family experience and combined with his clinical practice, he has written the book Clinical practice of ophthalmology in traditional Chinese medicine. In the book, the theory of stagnation of Qi and blood leading to disease was put forward, and radix stellariae was used most frequently in treating eye disease. From literature interview, we found that pang’s experience of radix stellariae in treating eye disease was its function of replenishing vital essence to improve eyesight.