Objective To reduce the recurrence rate and improving the hearing recovery effect in chronic otitis media patients with obstructive lesions in the attic, through the low bone intact-bridge tympanomastoidectomy.Methods A total of 23 patients with little severe or severe localized attic lesions granulation wrapped in ossicular chain blocking the entrance of tympanic antrum or affecting the attic drainage were included in this study.We have modified the intact-bridge tympanomastoidectomy to low bone intact-bridge tympanomastoidectomy (At the tympanic antrum entrance and lateral attic wall, we retained a more narrow low bone bridgestructure), completely cleared the localized lesions, released the activities limited ossicular chain and unobstructed the attic and middle tympanum drainage channel.And patients were followed up for 0.5~3 years.Results Before operations, the average pure tone auditory hearing threshold of all 23 patients was 43.91±9.90 dB HL,the preoperative air-bone gap was 24.04±5.10 dB.While the postoperative stable pure tone hearing test results were 33.17±7.63 dB HL and 14.70±4.52 dB, respectively.All patients had postoperative dry ear within 3 months.There was no recurrence of tympanic membrane perforation during follow-up.One patient had tympanic effusion(secretory otitis media) had accepted grommet insertion, 6 months after T-tube insertion, the tube was removed, and was followed up to 1 year.Conclusion The low bone intact-bridge tympanomastoidectomy by preservation of low bone bridge used in patients with chronic otitis media and obstructive lesions in the attic middle tympanum could reduce the recurrence rate and improve the recovery of hearing.

Objective:To image workstations in the necessity of desktop computer and data lines are connected and fixed in the desktop computer of defects, design a set of wireless transmission of picture archiving and communication system.Methods: Notebook computer with a wireless network using a wireless router, switch and set up a set of wireless image text transmission equipment.Results:The wireless transmission of honeycomb like structure covered with 802.11n standard data rates up to 600Mbps, frequency of 5Hz, multiple security protection by the hospital image filing requirements, which makes medical information resources to achieve full sharing. Conclusion: In 802.11n Wireless LAN PACS system architecture, the basic realization of the wireless transmission and real-time image display, image data for clinicians can within the hospital patients with real time view and its important role in the future development of hospital.

Objective To investigate the resistance of clinical isolates of P.aeruginosa in China during 2005.Methods Clinical isolates of P.aeruginosa from 7 teaching hospitals in China were collected and antimicrobial susceptibility were tested by Kirby-Bauer method.Results A total of 2 323 clinical isolates of P.aeruginosa were collected.The resistance rates of P.aeruginosa to antimicrobial agents from low to high were amikacin(22.5%),cefoperazone-sulbactam(22.8%),cefepime(27.6%),ceftazidime(28.9%),imipenem(31.3%),ciprofloxacin(31.7%),meropenem(33.7%),piperacillin-tazobactam(34.4%),aztreonam(36.8%),piperacillin(44.2%),ticarcillin-clavulanic acid(50.9%).Multi-drug resistant(MDR)and pan-drug resistant(PDR)strains accounted for 8.4% and 4.2%,respectively.Some(36.7%-53.4%)of the strains resistant to other antimicrobial agents were still susceptible to amikacin.Therefore,combination therapy of ?-lactams plus an aminoglycoside is usually indicated for serious infections caused by P.aeruginosa.By 'interpretative reading' of the susceptibility pattern of 'predictive drugs',we can predict the underlying resistance mechanisms.Conclusions The surveillance data indicate that the resistance of P.aeruginosa in China is relatively serious and its resistance mechanisms are very complicated.Close attention should be paid to this problem by physicians and clinical laboratory.

The scaffold material is one of the most key topics about the study of bone tissue engineering. The scaffold material of bone tissue engineering is divided into natural biomaterials and artificial synthesized biomaterials. Each kind of the materials includes organic materials and inorganic materials. Each scaffold material has its virtues and shortages. Although the existing scaffold materials merely carry some effects of the ideal materials require, the optimal scaffold may be designed using the necessary evidences provided by analyzing their virtues and shortages. This article summarized the study about the tissue engineering scaffold materials, such as porcelain and ceramics material, polymers material, natural organism-derived material and composite material.

Objective To investigate the clinical features,pathological features and prognostic factors of young patients with endometrial cancer.Methods One hundred and ten cases of endometrial cancer under 40 in Jiangning Hospital Affiliated to Nanjing Medical University from January 1st 2008 to January 1st 2012 were selected as the study group while one hundred and ten cases of cervical cancer over 40 in the same period as the control group.The clinical features and pathological features were compared between the two groups.Univariate and multivariate analysis were used to determine the prognostic factors.Results The occurrence rate of abnormal vaginal bleeding (74.5% (82/110)),vaginal drainage (22.7% (25/110)) and infertility (38.2% (42/110)) in the study group were significantly lower than those in the control group (59.1%(65/110),4.5%(5/110),3.6%(4/110),χ2=4.30,12.23,16.53,P<0.05),while the production time ((1.2±0.6) times),combination of hypertension (2.7% (3/110)) and diabetes (1.8% (2/110)) were significantly lower than those in the control group ((2.3±0.9)times,14.5% (16/110),10.0%(11/110),t=-5.69,χ2=23.61,8.26,P<0.05).The histological classification of the two groups was mainly based on endometrioid adenocarcinoma,and the pathological types were mainly based on adenocarcinoma,the differences were not statistically significant (χ2=0.75,1.56,P>0.05).There were differences in histology,PR,muscle,and lymph node metastases (χ2=5.39,4.29,4.89,P<0.05).Multivariate analysis of prognostic factors in young patients with endometrial cancer showed that histology,PR and muscle metastasis were independent risk factors for the prognosis of young endometrial cancer patients.Conclusion There are differences in clinical features and pathological features between young and elderly endometrial cancer patients.The census and prevention among young women should be strengthened and the individualized treatment and the prevention and control system should be upgraded.

Sepsis is one of the most important causes of death in critically ill children.The leading cause of sepsis is bacterial infection.The early diagnosis of bacterial infection allows initiation of appropriate antimicrobial therapy that strongly correlates with positive outcomes.At present,the methods of detection and identification of bacteria in our country are still at the level of blood culture and biochemistry,and they have the weakness of time-consuming process and lower positive rate.Therefore,it is very important to establish a rapid and sensitive diagnostic method for early diagnosis of bacterial infection.In recent years,with the rapid development of molecular detection technology,some new molecular biological technologies can not only improve the detection accuracy and sensitivity,but also reduce the detection hours and expand the detection pathogen spectrum.Nowadays,they have been applied to bacteria classification and identification.There are two kinds of molecular biological technology that are applied at present.One is based on nucleic acid detective technology,such as nucleic acid amplification,DNA sequencing,gene chips,etc.The other is based on proteome technologies,such as biological mass spectrometry.In this paper,the application of recent molecular biological techniques in the rapid detection of bacteria is reviewed.

Postoperative pancreatic fistula (POPF) is the most common complication after pancreaticoduodenectomy (PD) and remains a challenge to pancreatic surgeons.In pancreaticojejunostomy,the methods of reconstruction,experience and operational techniques of surgeons are closely related to POPF.Based on a literature review and on personal experience,the author presented the basic requirements and principle in reconstructing a safe pancreaticojejunostomy (PJ).The traditional methods of pancreaticojejunostomy and their recent developments were evaluated,with their advantages and disadvantages compared.The indications of various types of PJ and the special skills required were summarized.According to his own experience,the author described in detail his recommended method of anastomosis.

Objective To explore the ways to strengthen the mode and effect of the standard community management of the diabetes,and the management model of diabetic mellitus that adopt to current situation of China.Methods 80 diabetics patients were divided into intensive group and common group,and the period of the treatment is three consecutive months.We observed the levels of FBG,2hPG,HbA1c and the cost of drugs.Results The levels of FBG(6.82 ± 1.23),2hPG[(9.51 ± 2.18)mmol/L]and HbA1c(7.52 ± 1.31)％ in intensive group were significantly lower than common group[(8.65 ± 2.31)mmol/L、(12.22 ± 3.11)mtmol/L,(10.32 ± 3.51)％](t =3.12,3.25,3.56,3.69,all P ＜ 0.05).The cost of drugs in intensive group[(621.5 ± 204.5)yuan]was significantly lower than common group[(796.5 ± 240.6)yuan](t =3.69,P ＜ 0.05).Conclusion The ways to strengthen the mode could spend less but control disease well,and improving the existing community diabetes management should be truly effective in reducing medical costs.

Intestinal trefoil factor(ITF)is a low molecular weight polypeptide expressed in intestine. ITF is also found in the brain,respiratory,eyes and so on.To study recombinant ITF will have an important impact for the treatment of gastrointestinal disease, respiratory tract disease, eyes disease and so on.

Essential hypertension is a multifactorial disease. Many experimental studies have elucidated the role of oxidative stress and atherosclerosis in the pathogenesis of essential hypertension. Apolipoprotein E is a plasma protein that is found to have antioxidant properties, and it also protects against atherosclerosis. Interestingly, the biological function of apolipoprotein E is strongly affected by polymorphisms in its gene. Based on this evidence, our aim was to investigate the association of apolipoprotein E gene polymorphisms with essential hypertension. Methods: This study was conducted on 70 hypertensive patients and 73 control participants recruited from the Balok governmental health clinic in Kuantan, Pahang. The polymerase chain reaction restriction fragment length polymorphism assay (PCR-RFLP) was used for determination of the apolipoprotein E genotype. Our results were also verified later by direct sequencing of the amplicons. Results: There was no significant association of apolipoprotein E allele or genotype frequencies with hypertensive disease or blood pressure levels, although the E4 allele was slightly more frequent in the hypertensive patients than in the control group (OR=1.055; 0.471–2.359, CI 95%). To improve the precision of the study and to settle the controversies among similar studies meta-analysis was performed; however it revealed a net nonsignificant association between the apolipoprotein E4 allele with essential hypertension in the combined population. Conclusion: Our data and the meta-analysis findings provide evidence that apolipoprotein E gene polymorphism has no direct significant association with hypertension.