Objective To investigate the recurrent etiologic causes in otitis media with effusion(OME).Meth-ods The patients with OME had been conducted clinical evaluation and ventilation tube insertion.Among 255 cases observed,85 cases were recurrence within one year,while 170 cases were recovered.Factors including age,gender, course of disease,smoking environment,recurrent respiratory tract infection,chronic nasal sinusitis,nasal struc-tural abnormalities,adenoid hypertrophy/nasopharyneal lymphadenosis,and mastoid gasification condition,histo-ry of tube insertion,duration of ventilation tube were evaluated by univariate analysis and multivariate logistic re-gression analysis and compared among preschool children,school age children and adults.Results In univariate a-nalysis,it was strongly associated with age,higher prevalence of recurrent respiratory tract infection(χ2= 22.546,P= 0.000),chronic nasal sinusitis(χ2= 5.211,P= 0.023),adenoid hypertrophy/nasopharyneal lymphadenosis(χ2= 10.338,P= 0.002),mastoid pneumatization adverse(χ2= 15.196,P= 0.000)and duration of ventilation tubeand (χ2= 11.347,P= 0.001).In multivariate logistic regression model,five of these factors were found to be predictors of recurrent OME,which were younger age,recurrent respiratory tract infection (P= 0.001,OR= 2.992),adenoid hypertrophy/nasopharyneal lymphadenosis (P= 0.021,OR= 2.198),mastoid pneumatization adverse (P= 0.000, OR= 3.433)and duration of ventilation tube(3~6 m)(P= 0.010,OR= 2.237).When comparing the difference a-mong preschool children,school age children and adults,recurrent respiratory tract infections in preschool and school age children had the statistic significance(P<0.05),and adenoid hypertrophy in preschool had the statistic significance(P<0.05).Conclusion Younger age,recurrent respiratory tract infection,chronic nasal sinusitis,ade-noid hypertrophy/nasopharyneal lymphadenosis,mastoid pneumatization adverse and less time of ventilation tube are the risk factors causing recurrence of OME.When comparing the recurrent preschool children,school age chil-dren and adults cases,more recurrent respiratory tract infection in preschool and school age children have statistic significance,and adenoid hypertrophy in preschool has the statistic significance.

Objective To study clinical characteristics and treatment effects on old patients with sudden sen-sorinerural hearing loss .Methods To compare clinical characteristics and effects of 357 cases of unilateral SSHL from Sep ,2013 to Mar ,2015 in the First Affiliated Hospital of Zhengzhou University .The patients were divided into 2 groups :the old group(66 cases)≥60 years ,and the control group(291 cases)<60 years .All cases were trea-ted with drugs to supply nutrition to the nerves and drugs to improve circulation and intratympanic injection of dexa-methasone .Results The genders ,ear sides ,concomitant symptoms and onset time ,degrees of hearing in 2 groups showed no significant difference (P>0 .05) ,but there were less patients with the type in low frequencies (1 .51% ) and more with the type in high frequencies (22 .73% ) and the type in total deafness (50 .0% ) than those of in the control group(14 .43% ,15 .44% ,39 .52% ) .The old group had more patients with systemic diseases (60 .61% ) and the hearing impairment of the other ear (57 .58% ,P<0 .05) .Total effective rate was 70 .03% ,which the old group and the control group were 60 .61% and 72 .16% ,respectively .The difference had no statistical significance (P>0 .05) .The old group's complete recovery rate was 10 .61% ,which was significantly lower than that in the control (P<0 .05) .Conclusion The old group has more patients with systemic diseases and the hearing impairment of the other ear .Their hearing impairment more easily occurs in the type in high frequencies and the type in total deafness . But the complete recovery rate is low ,the doctors and patients should have a reasonable expectation .

BACKGROUND: Previous studies have confirmed that 6-hydroxydopamine is capable to increase the expression of divalent metal transporter-1 and reduce the expression of ferroportin-1 in the neurons and microglia, which may lead to iron deposition in the substantia nigra after Parkinson’s disease. However, it is unclear whether 6-hydroxydopamine can play diverse roles in astrocytes.
OBJECTIVE:To observe the effects of 6-hydroxydopamine on the expression of divalent metal transporter-1 and ferroportin-1 in rat C6 glioma cel lines.
METHODS:C6 glioma cell lines from rats were cultured in 10 μmol/L 6-hydroxydopamine for 24 hours. Then, protein expressions of divalent metal transporter-1 and ferroportiner-1 were measured by western blot method.
RESULTS AND CONCLUSION:The protein expressions of divalent metal transporter-1 and ferroportin-1 in C6 glioma cell lines were increased by 2.5 times (P < 0.01) and 1 time (P < 0.05), respectively, after treatment with 6-hydroxydopamine. These findings indicate that 6-hydroxydopamine can promote iron transport rate in astrocytes by increasing both divalent metal transporter-1 and ferroportin-1 expressions, and astrocytes has a different response to 6-hydroxydopamine from neurons and microglia.

Objective To observe the changes of hippocampal NogoA-NgR1 signaling on postoperative cognitive function (POCD) in aged mice, and explore the potential underling mechanism.Methods Isoflurane anesthesia and laparotomy were applied to establish the POCD model.Forty aged male C57BL/6 mice were randomly divided into the following four groups (n=10): group O2+saline (group OS), group O2+NEP1-40 (group ON), group isoflurane anesthesia+laparotomy surgery+saline (group SS), and group isoflurane anesthesia+laparotomy surgery+NEP1-40 (group SN).Cannula placement was performed into lateral ventricle 7 days before the surgery.Animals were subjected to an administration of NEP1-40 (20 μg/2 μl) or isochoric saline via intracerebroventricular injection once daily for 8 consecutive days, injection was given from 2 h before isoflurane anesthesia to the last behavioral test.Open field test was performed at 5th d after operation.Contextual and cued fear conditioning training and testing were exhibited at 6th and 7th d after operation, respectively.The hippocampus was harvested 2 h after the behavioral test.Western blot was used to detect the expressions of NogoA, NgR1, RhoA, ROCK2 and GAP43.Golgi staining was applied to measure the changes of dendritic spines in hippocampal CA1 area.Results Compared with the groups OS and ON, the freezing time in the contextual fear conditioning test was significantly decreased, the contents of NogoA, NgR1, RhoA and ROCK2 were significantly increased, the content of GAP43 and the number of dendritic spine were significantly decreased in group SS (P<0.05).Compared with the group SS, the freezing time in the contextual fear conditioning test was significantly increased, the contents of RhoA and ROCK2 were significantly decreased, the content of GAP43 and the number of dendritic spine were significantly increased in group SN (P<0.05).Conclusion Over-activated of hippocampal NogoA-NgR1 signaling participated in the pathogenesis of POCD in aged mice.

Objective:To research the number and function of monocyte-macrophages in patients with chronic active hepatitis B. Methods:The 51 chronic viral hepatitis B( CHB) patients were selected randomly,which consisted of 20 cases of mild-moderate,31 cases of severe group and 13 cases of healthy controls. PBMCs were separated by percoll. Monocytes were tagged by CD14,the molecules CD80,CD86,HLA-DR and CD163 were detected by flow cytometry which expressed on the surface of PBMCs. Serum cytokine were detected for IL-10, IL-12 and IL-23 by ELISA. The distribution of CD68 was detected in the liver by immunohistochemical staining. Results:The expressions of CD80 for all chronic hepatitis B patients were lower than the controls respectively,no matter mild-moderate or even severe group. Similarly,the HBV patients expressed lower level of CD86 in the peripheral blood mononuclear cells when compared with the control group. Furthermore, there was statistically difference between the levels of CD86 in severe group compared with control group (P<0. 01). As the expression of CD80 and CD86,the levels of HLA-DR in the patents had also declined when compared with controls. While the HLA-DR levels in both the mild-moderate HBV hepatitis groups were statistically significant higher than the severe group (P<0. 01). Different from the above all,the expression of CD163 in all chronic HBV hepatitis was higher than the control group. The CD68 positive cells in chronic HBV patients were observed and infiltrated increasingly in portal area and hepatic lobules (P<0. 05). There were statistically significant differences of IL-10 levels between the mild-moderate group,severe group and the control group,respectively (P<0. 01). Conclusion:Macrophages have participated in the pathological lesions of liver in CHB patients,among peripheral blood mononuclear cells,the phenomena of imbalance between type M1/M2 and polarization to type M2 have been observed,which participated in the development of the chronicity of CHB.

Objective To evaluate the changes of serum tumor markers of carbohydrate antigen 125 (CA125),carbohydrate antigen 199 (CA199),carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) during anti-tuberculosis treatment in patients with active pulmonary tuberculosis and tuberculous pleurisy.Methods This research was a prospective study.Sixty-three patients with active pulmonary tuberculosis and 24 patients with tuberculous pleurisy underwent blood samplings before treatment,2 and 6 months after treatment.Centaur XP chemiluminescent immunoassay was used to test serum levels of CA125,CA199,CEA and SCC.Thirty healthy subjects were included as controls.Student t-test was used to compare continuous variables,and chi-square test or Fisher exact test was used to compare categorical variables.Serial changes of serum tumor markers levels pre-and post-treatment were analyzed by repeated measures analysis of variance.Binary Logistic regression model was used for multivariate analysis.Results The mean serum CA125 level of the 63 patients with active pulmonary tuberculosis pre-treatment was (64.4± 30.4) U/mL,which was significantly higher than that of healthy controls ([12.7±5.5] U/mL,t=11.98,P＜0.01).The mean serum CA125 level decreased to (16.9±6.1) U/mL after 6 months standardized treatment,which was significantly lower than that before treatment (t=12.74,P＜0.01).While compared with healthy controls,the serum level of CA125 in patients who had completed the standardized treatment was not significantly different (t =0.94,P =0.348).When compared with the healthy controls,serum CA199,CEA,SCC levels in patients with active pulmonary tuberculosis before and after treatment showed no statistically significant difference (P＞ 0.05).Univariate analysis and multivariate analysis by Logistic regression analysis showed that bilateral pulmonary tuberculosis (x2 =7.746,P=0.006; OR=6.99,95％CI:1.73-28.22) and cavity pulmonary tuberculosis (x2 =6.254,P=0.012; OR=7.64,95％CI:1.64-35.35) were associated with increased serum CA125 level.The mean serum CA125 level of 24 cases of tuberculous pleurisy pre-treatment was (81.2 ± 37.6) U/mL,which was both significantly higher than that of patients with active pulmonary tuberculosis (t=2.153,P=0.034) and that of healthy controls (t=12.05,P＜0.01).Similarly,CA125 levels sharply decreased to (15.5 ± 7.3) U/mL after 6 months standardized treatment,which was not statistically significant compared with the control group (t=0.450,P=0.652).However,CA199,CEA and SCC levels in tuberculous pleurisy pre-and post-treatment were all not statistically different from those of healthy controls (all P＞0.05).Conclusion Serum CA125 can be used as a marker for assessing the disease progression and therapeutic efficacy for patients with active pulmonary tuberculosis and tuberculous pleurisy.

Objective To explore the status quo and the correlation of professional practice environment and job burnout in head nurses. Methods Totally 646 head nurses from city state hospitals of Hunan Province was selected by cluster sampling method. Participants were investigated by using the Chinese Version of Profession Practice Environment Scale for Head Nurses and Maslach Burnout Inventory. Results The professional environment score was 215.95±22.81, which was in the moderate level. The score of emotional exhaustion (EE) in head nurses was 24.56 ± 10.64, depersonalization (DP) was 8.92 ± 4.17 and personal accomplishment (PA) was 35.55±13.08, all stating moderate burnout. Meanwhile, the scores of EE and DP were negatively correlated with professional practice environment (r=-0.350--0.161, P≤0.01), while the PA was positively correlated with professional practice environment (r=0.078- 0.271, P≤0.01). Conclusions Professional practice environment in head nurses is correlated with job burnout. Hospital leaders should pay more attention to head nurses′professional practice environment to decrease job burnout in head nurses.

Objective To screen the differential proteins in the brain (neocortex and hippocampus) between the rats with cortical dysplasia (CD) and control ones,and investigate the role of their alteration in the development of epilepsy in CD.Methods Cortical dysplasia was induced in rat pups via in utero delivery of BCNU.A two-dimensional electrophoresis (2-DE)-based approach was used to construct the expression profiles of proteins in both the neocortex and hippocampus at different age groups (postnatal day 7 and 60) and to detect proteome changes between CD rats and control ones.Following gel image analysis,protein spots that differed in abundance between CD and control rats were identified by using Matrx-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) and MS/MS.Results A total of 57 kinds of protein were screened out (P ＜ 0.05),in which 35 were found up-regulated and 22 were down-regulated compared with the control,35 from neonatal stage (postnatal day 7) and others from adult stage.Finally,12 among them were identified,including tubulin,alpha-lB,Beta-actin,tubulin beta-2A,GAP-43,UbCKmit,GAPDH and TMBr-3,etc.Conclusions Changed expression of specific proteins which were found in our study are involved in construction of brain 's cytoskeleton,synaptic function,mitochondrial function and so forth.Thus,they may be related to the pathogenic mechanisms of epileptogenicity of CD.

Objective To investigate the frequency of JAK2 V617F mutation and JAK2 V617F mutation allele burden in patients with essential thrombocythemia (ET), and explore the relationship between mutation and hematological parameters and coagulation function. Methods The clinical and laboratory parameters of 90 ET patients were analyzed. JAK2 V617F mutation was detected by AS-PCR and the mutation allele burden of JAK2 V617F was detected by qPCR. The correlation between mutation frequency and mutation burden of JAK2 V617F and blood laboratory parameters were investigated in ET. Results JAK2 V617F mutation was found in 50 patients (55.6 %). RBC [(4.67±0.89)×109/L vs (4.04±0.99)×109/L, P =0.003], WBC (11.64±5.20)×109/L vs (9.11±4.11)×109/L, P = 0.014], HCT (0.41±0.07) vs (0.36±0.07), P =0.005) in the JAK2 V617F mutated group were higher than those in the wild-type group. PT in mutated patients was longer than that in wild-type group [(13.18±1.63) s vs (12.02±1.24) s, P = 0.000]. The JAK2 V617F mutation allele burden was (29.91 ±18.63) %. No significant correlation was found between JAK2 V617F mutation allele burden and hematological parameters such as WBC, RBC and Plt (all P>0.05), but the JAK2 V617F mutation allele burden had a significant correlation with FDP (r = 0.456, P = 0.001). Conclusions JAK2 V617F mutation occurs in significant percentage patients with ET. Detection of JAK2 V617F mutation allele burden at diagnosis may play an important role in the early prevention of vascular events.

Objective To analyze the impact of controlled hypotension (CH) by cerebral oxygen saturation (rSO₂) monitoring on brain protection and cognitive function in anesthetized patients. Methods A total of 200 patients undergoing rSO₂-monitored CH were enrolled. Patients were divided into normal group (n=137) and postoperative neurocognitive disorder (PND) group (n=63) based on whether they developed PND after surgery. Preoperative clinical data were collected. Univariate analysis was performed to identify factors influencing the occurrence of PND in rSO₂-monitored CH patients. Multivariate binary logistic regression analysis was used to screen for independent risk factors. A predictive model was constructed based on the identified independent risk factors, and its predictive value was evaluated using receiver operating characteristic (ROC) curve analysis. Results Age, intraoperative blood loss, vascular surgery, 20-minute rSO₂ monitoring values, 20-minute central venous pressure (CVP), history of hypertension, stroke and operative time were identified as factors affecting the occurrence of PND in rSO₂-monitored CH patients (P < 0.05). Independent risk factors for PND included age >55 years, high CVP during 20 minutes of surgery, low rSO₂ monitoring values during 20 minutes and undergoing vascular surgery (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for the predictive model was 0.855. Conclusion Clinically, the risk of PND in rSO₂-monitored CH patients (age >55 years, undergoing vascular surgery) can be reduced by controlling intraoperative CVP to minimize blood loss and by timely adjustment of treatment plans based on rSO₂ monitoring results.