Objective:To investigate the pathophysiological mechanism,clinical menifestation and radiographic diagnosis of cholesterol granuloma following chronic supperative otitis media.Method:Six cases of CG following chronic suppurative otitis media, confirmed by surgery and pathology,were reviewed and analyzed.Result:CG frequently accompanied with other middle ear diseases，and was shown as a high signal intensity on both T1-and T2-weighted images in magnetic resonance imaging(MRI).Conclusion:It was postulated that the obstruction of pneumatized temporal bone air cells,caused by other middle ear diseases such as cholesteatoma and tympanosclerosis,might be the pathophsiological mechanism of CG.The evaluations of computed tomography(CT) and clinical manifestation were limited to distinguish CG from cholesteatoma or other neoplasm,while the MRI can be of great value to characteristic diagnosis.

Objective To evaluate the effectiveness of a health education program based on the three level maternal and child health care networks in terms of acceptability of HIV tests in pregnant women. Methods A field study approach was adopted. Pregnant women in two sites who were similar in their social features were selected as intervention group and control group,respectively.Based on the baseline survey,the intervention group was exposed to one-year long health education activities on prevention of HIV related MTCT via lectures,broadcasting and educational materials etc.The effectiveness of the interventions was evaluated by interviewing the pregnant women in the two groups via questionnaires and comparing change of HIV test rates pre-and post-interventions. Results A total of 1 541 pregnant women were interviewed,with 933 women in the intervention group and 618 women in the control group.After one year intervention,the rate of HIV-testing during pregnancy in the intervention group was raised from 34.27% to 72.49%,while 5.83% to 20.38% in the control group.The rate of HIV-testing during pregnancy in the intervention group was 52.11% higher than in the control group (?2=24.60,P

Objective To confirm the deviation between the present charge and real cost of nursing by comparing them between PICC and jugular veins catheter,and the advantages and disadvantages were weighed between them in tumor patients undergoing chemotherapy.Methods The cost of manpower,financial resources or materials for 106 patients with PICC,68 patients with jugular veins catheter were measured,accounted and statistically analyzed with the ladder sharing method for project cost.Comparing the cost between calculation cost and current charging standard,and the cost and clinical application was studied.Results The real cost of PICC was (2259.99±30.99)Yuan and current charging standard was 1532.79 Yuan,the deviation was -727.20 Yuan,and the real cost of jugular veins catheter was (393.86±33.93) Yuan,and current charging standard was 292.13 Yuan,the deviation was -101.73 Yuan.The complication rate was 12％ in PICC,17％ in jugular veins catheter.The real cost of nursing on PICC and jugular veins catheter was higher than current charging standard,and the real cost of single nursing on PICC was 5.74 times higher than jugular veins catheter.The cost remains unchanged with 4～6 course of chemotherapy treatments in a year.Conclusions The advantages of PICC are more than jugular veins catheter,so the preferred choice is PICC,and jugular veins catheter comes secondary.

Objective To establish the real-time fluorescence quantitative PCR method for the detection of bifidobacteria in human fecal samples, and to provide an effective means for measuring intestinal bacteria. Methods Total DNA of bacteria was extracted from 60 cases of children's fecal samples. Three primers of bifidobacteria based on the 16S ribosomal RNA (16SrRNA)which possessed specialities of bacteria as amplified region were designed.The part of amplified 16SrRNA gene sequences was used as standard production.The serial dilution of standard was analyzed to build an absolute quantitative standard curve with SYBR GreenⅠ dye method, and the bifidobacterium contents in sixty human fecal samples were calculated. The sensitivity of the reaction was calculated by detecting the lowest detectable standard which determined the sensitivity of the reaction. The PCR products’melting curve was used to evaluate the specificity.The coefficient of variation (CV)of different batches of standard with the same concentration was used to evaluate the stability of reaction.Results The length of PCR product fragment which was used to build the standard curve was about 6 1 3 bp, the sequencing result was consist with the goals, and the standard sample of bifidobacteria was successfully established in real-time fluorescence quantitative PCR.The standard curve showed a good linear relationship with R2=0.999.The minimum detection value was 1.48×102 copies per reaction.The melting curve of real-time fluorescence quantitative PCR was a single peak.The test samples were batched and then examined by fluorescence quantitative PCR.The CV of standards’ Ct values which calculated from the standard (1.48 × 103 -1.48 × 107 copies · μL-1 )were 2.94%, 3.39%, 3.54%,3.08%,and 3.34%,respectively.The contents of bifidobacteria in fecal from 60 children was 7.77± 0.86(copies · g-1 wet fecal)transformed by logarithmic.Conclusion The established real-time fluorescence quantitative PCR method has high sensitivity, strong specificity and good repeatability, which is suitable for detection of human fecal bifidobacteria content.

Objective To investigate the level of urinary protein in type 2 diabetic patients with different glucose excursion and investigation the effect of the glucose excursion on early diabetic nephropathy.Methods Fifty-six type 2 diabetes patients were divided into two groups by the level of glycosylated hemoglobin(HbA1c),good glycemic.Patients in control group with HbA1c ＜ 7.0％ and patients in poor glycemic control group with HbA1c ＜ 7.0％.Microalbuminuria,urine transferring (UTRF),α1-microglobulin (α1-MG) and 32-microglobulin(32-MG) were measured.All the patients were monitored using the continuous glucose monitoring system (CGMS),and mean amplitude of glucose excursions (MAGE) were analyzed.Patients were divided into two groups by MAGE,one group's MAGE was lower than 3.9 mmol/L,and another group's MAGE was higher than 3.9 mmol/L.Urinary proteins were measured and analyzed in the two groups.Results In the poor glycemic control group,the levels of microalbuminuria,UTRF and albunin/ creatinine(A/C) rate were (81.28 ±44.13) mg/L,(4.54 ± 1.54) mg/L and (22.17 ± 14.52) mg/mmol significantly higher than that in the good glycemic control group((21.63 ± 10.16) mg/L,(2.48 ±0.29) mg/L and (2.05 ± 0.76) mg/mmol; t =4.758,5.360,4.805 ; P ＜ 0.05).Fasting C peptide in the poor glycemic control group was (1.01 ± 0.13) ng/ml,significant lower than that in the good glycemic control group ((1.51 ± 0.21) μg/L;t =4.826;P ＜0.05).The levels of A/C rate,α1-MG and β2-MG in the group with MAGE above 3.9 mmol/L significantly higher than those in the group with MAGE below 3.9 mmol/L(t =4.358,8.641,12.702;P ＜ 0.05).Conclusion Both persistent hyperglycemia and blood glucose variability could influent diabetic nephropathy.

[ ABSTRACT] AIM:To study the effect of interleukin-1β( IL-1β) on neuron activation during the process of me-dial temporal lobe epilepsy ( MTLE ) .METHODS: IL-1β, rapamycin [ an inhibitor of mammalian target of rapamycin (mTOR)]and lentiviral transfection to knockdown PI3K-p85 were used to pre-treat the neurons.The protein levels of PI3K-p85, p-Akt, p-p70S6K and MAP2 were detected and the relationship among the tested cytokines was analyzed.The neuron endocytosis was observed in each group.RESULTS:IL-1βincreased the protein levels of PI3K-p85, p-Akt and p-p70S6K, up-regulated the expression of PI3K-p85 binding with IL-1RI in the neurons, and increased the neuron endocyto-sis compared with control group (P<0.05) .These processes were inhibited by rapamycin and silence of PI3K-p85 (P<0.05).Inhibition of the PI3K-p85 binding to IL-1RI decreased the protein levels of p-Akt, p-p70S6K and MAP2 which were increased by IL-1βstimulation (P<0.05).CONCLUSION: IL-1βactivates PI3K-p85 by binding with IL-1RI to promote the activation and proliferation of neuron synapses via PI3K/Akt/mTOR signaling pathway, which might be one of the mechanisms in MTLE chronic progress.

Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder (ADHD) and the differences among subtypes of ADHD.Methods Ninety children with ADHD were diagnosed in Department of Neurology, the Children's Hospital Affiliated to Capital Institute of Pediatrics between June 2012 and June 2013, including 75 boys and 15 girls,6-14 years old [(9.5 ± 2.4) years old], and among them there were 55 cases of ADHD-combined type, 25 cases of ADHD-inattentive type, and 10 cases of ADHD-hyperactive impulsive type.Thirty healthy children whose age and sex matched with ADHD group,came from Beijing and the surrounding area,were selected as the healthy control group,including 23 boys and 7 girls,6-14 years old [(9.2 ± 2.9) years old].Two groups underwent full overnight sleep assessment.Results The latency of rapid eye movement(REM) in children with ADHD was (146.58 ± 47.28) minutes, and the sleep latency was 19.00 minutes [(8.25-37.50) minutes];while the latency of REM in healthy control group was (87.55-± 13.59) minutes, and the sleep latency was 9.00 minutes [(3.50-13.63)minutes].Compared with healthy control group, children with ADHD demonstrated the increased latency REM and sleep latency, and decreased sleep efficiency,the increasing times of awakening and total duration,and these differences were all statistically significant(all P ＜ 0.05).The percentage of non-rapid eye movement(NREM) phase Ⅱ in ADHD hybrid was lower than the ADHD attention-deficit(t =2.012,P ＜ 0.05).Sleep latency in ADHD attention-deficit was longer than the ADHD hybrid(t =2.964,P ＜ 0.05).No statistical differences were found among the various types in other indicators.The prevalence of periodic limb movements in sleep(PLMS) was 27.78％ (25/90 cases) in ADHD group and the prevalence of PLMS was 3.30％ (1/30 cases) in the healthy control group.The differences in prevalence between 2 groups were statistically significant (x2 =8.053, P ＜ 0.05).Conclusions Children with ADHD significantly display more problems with sleep.Sleep latency and NREM Ⅱ are different between ADHD attention-deficit and ADHD hybrid.

Objective To investigate the molecular mechanism for change in permeability in brain microvascular endothelial cells (bEnd.3) induced by lipopolysaccharide (LPS). Methods Monolayers of bEnd.3 were exposed to LPS,in the presence or absence of exoenzyme C3 transferase. We monitored the monolayer barrier integrity by transendothelial electrical resistance assay (TEER),activity of RhoA by pull down assay,NF-κB by luciferase reporter assay,and F-actin dynamic structure by Rhodamine-phalloidin staining. Results Incubation of monolayers with LPS caused substantial barrier hyperpermeability. Under the had been treated for 3 and 12 h with LPS (P＜0.05). Such effects could be inhibited partly by pretreatment of RhoA inhibitor exoenzyme C3 transferase. LPS activated RhoA and NF-κB at 0.5 h. The C3 transferase could significantly reverse the NF-κB activation (P＜0.05). The F-actin rearrangments displayed in a time-dependent manner and occurred originally after the stimulation of LPS for 3 h,which could be diluted by the pretreatment of C3 transferase as well. Conclusion LPS induces the disruption of F-actin cytoskeleton and brain microvascular endothelial barrier integrity,in part,through RhoA and NF-κB activation. The mechanism underlying this pathophysiological effect of RhoA is to influence the disruption of the F-actin cytoskeleton by regulating NF-κB activites.

Objective To explore nurses' bonus assessment and distribution methods based on the information technology platform and to improve the efficiency of nursing management. Methods We build a hospital informa-tion platform in order to collect nursing work efficiency data by using existing computer information network. We distributed the bonus through the information platform according to evaluate nursing quality and performance effi-ciency. Results After the information flatform used for 2 years,the satisfaction of nurses with different professional titles and different experience showed no significant difference (P>0.05). The time of department management person-nel collecting and distributing data change from [103.75 (180.00,215.00)] min per month to [42.50 (60.00,90.00)] min per month.The difference showed statistical significance(P<0.05). Conclusion The technology platform can im-prove the satisfaction and the nursing management efficiency.

Objective To investigate the clinical,electroencephalogram (EEG) and genetic features of nocturnal frontal lobe epilepsy (NFLE) in the Chinese population.Methods Clinical examination,EEG recording,mutation screenings in transmembrane domains 1-3 of neuronal nicotinic acetylcholine receptor (nAChR) α4 (CHRNA4),β2 (CHRNB2) and α2 (CHRNA2) using PCR amplification and sequencing were carried out on 6 patients and some members in 3 families with NFLE.Results Among 6 patients (5 male) with NFLE,the mean age was (20.5±11.5) years and the mean age at onset was (7.3±5.5) years.Clinical features included seizures of dystonic posturing in 2 patients and seizures of hyperkinetic movements in 4 patients with the maximum frequency of 6 seizures within one night.The ictal and interictal video-EEG (VEEG) of frontal lobes showed epileptic discharges,slow wave activity,normal activity or electrode artifacts.There weren' t abnormity in other clinical examination and neuroimagings.No mutations were identified in the genes screened.Conclusion NFLE is a heterogenetic epilepsy syndrome.