Objective To observe the effects of the re-therapeutic on later stage of sudden deafness.Methods Patients who met the criteria for sudden deafness and showed poor response tO conventional therapy over two months were recruited and assigned randomly for re-therapy.The pure tone audiometry was conducted before and after re-treatment in 103 patients(112 ears).Sodium bicarbonate and dexamethasone were iniected by intravenous drip for two days and batroxobin 5 BU for 6 days.Statistics were made in the effecency of the re-treatment.Results The effective rate of re-treatment group was 46.43% and the difference was significant before and after retreatment(P<0.01).Conclusion Combined use of sodium bicarbonate dexamethasone and batroxobin is effective in re-treating later sudden deafness.

Objective To retrospectively investigate the endoscopic characteristics and pathological features of colorectal polyps in over-aged patients (≥80 years). Methods The 1617 colonoscopies performed between January 2006 and December 2010 were enrolled in our retrospective analysis. The detection rate, size, location, form and pathological feature of polyps in 150 over-aged patients were investigated, and they were compared with those in 832 young patients (＜60 years) and 635 old patients (60-79 years) with colorectal polyps. Results The detection rate of polyps was 62.0% in over-aged group, and was significantly higher than in young group and old group (30.2% and 48.7%, respectively, χ2=56.58 and 8.64,both P＜0.001). The malignant transformation rate of ascending colon polyp was 5.4% in over-aged group, and was significantly higher than in young group (1.2%, χ2=4.90, P＜0.05), but there was no significant difference between over-aged group and old group (3.9%, χ2=0.36, P＞0.05). There were no statistical differences in canceration rate, polyp diameter, morphology and adenomatous polyp rate among the three groups. The malignant transformation rate was significantly increased in adenomatous polyps with diameter over 2 cm, but didn't reach statistical significance. Conclusions The polyp detection rate is noticeably higher in the over-aged than in the old and the middle-aged, and the malignant transformation probability is also increased. The colonoscopy indications in the high risk age groups should appropriately be broadened, they should receive regular intervals follow-up, and undergo polypectomy in time if necessary.

BACKGROUND:Atlantoaxial anatomical structures were special. Compared with thoracolumbar vertebrae, there is no fixed anatomical marker for screw implantation. Moreover, pedicle structural variation is great. The current consensus view is to suggest an individualized program of pedicle screws. The development of orthopedic digital software technology provides a novel manner for preoperative design.
OBJECTIVE:To original y design 3D matrix model, to observe atlas pedicle channel, pedicle screw safety zone, to measure optimal program for screw fixation, and to simplify preoperative design of entering pedicle screw.
METHODS:Continuous atlas CT data of 12 healthy adults in picture archiving and communication system of People’s Hospital, Three Gorges University were imported into Mimics 10.01 software. There were seven males and five females, at the age of 30-65 years old, averagely 45 years. After three-dimensional reconstruction, the three-dimensional reconstruction models were imported into 3Dmax 2009 as .dwg format. The reference three-dimensional planes and the sites of nail insertion were determined by the atlas modeling. The modeling consisted of 17×17×2 elements and the transverse section angles ranged from 0° to 40° and the sagittal section angles ranged from 0° to 40° with a space of 2.5°. 578 elements were used to simulate pedicle screw array model. Perspective observation showed that the diameter was 3.5 mm, and length was 22 mm in pedicle channel. Thus, safety area, best screw channel and screw angle were analyzed.
RESULTS AND CONCLUSION:The total number of elements in the matrix study was 17×17×2×12 in 12 subjects. 175 screws in total of 6 936 units could safely meet the operative standard. No significant difference in the number of pedicle screw between left and right sides (P>0.05). Results indicated that the digital three-dimensional modeling technology is an effective, simple, accurate way in the preoperative design and measurement for atlas pedicle surgery.

Objective To investigate the expression of interleukin (IL)-34/colony stimulating factor(CSF)-1R in the process of transforming growth factor ( TGF)-β1 inducing epithelial-mesenchymal transition ( EMT) of human alveolar epithelial cells A549 cells.Methods A549 cells were cultured in vitro.CCK 8 was used to test the influence of the proliferative rate of A549 cells which were stimulated by TGF-β1 at different concentrations and time points .A549 cells were stimulated by 5μg/L TGF-β1 at 0 hour, the 12th hour, the 24th hour, and the 48th hour.Western blotting was adopted to detect changes of the following proteins: α-smooth muscle actin (α-SMA ) , E-cadherin ( E-Cad ) , matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1). Real-time PCR was adopted to detect changes of the following genes: IL-34 mRNA, CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA.Results TGF-β1 had no significant influence in the proliferation of A 549 cells compared with the control group(P>0.05).TGF-β1(5μg/L)stimulated A549 cells at different time point (0 hour, 12, 24, 48 hours), compared with the control group .The epithelial phenotype E-Cad protein was gradually down-regulated ( P <0.01 ) , while the mesenchymal phenotype α-SMA protein was gradually up-regulated ( P <0.01 ) and the protein of MMP-2 increased gradually (P<0.01).The protein of MMP-9 increased firstly and then was reduced (P<0.01),the peak was at the 24th hour.The protein of TIMP-1 was firstly transiently increased and then reduced (P<0.01), the minimum was at the 48th hour.Compared with the control group , the gene of IL-34 mRNA increased gradually (P<0.01), and the genes of CSF-1R mRNA, MMP-2 mRNA and MMP-9 mRNA increased firstly and then decreased ( P <0.01), which were peaked respectively at the 24th hour, the 24th hour, the 12th hour, respectively.Conclusion In the process of TGF-β1 inducing A549 cells transition,there is accompanied with the expression of IL-34/CSF-1R.

Objective:To explore the effect of comprehensive intervention program based on the concept of fast track surgery in early enteral nutrition tolerance and rehabilitation in patients with esopha geal cancer.Methods:93 selected patients were divided into the intervention group and the conventional control group according to the admission time.Patients in intervention group were treated with comprehensive intervention,and control group were given routine nursing care.Enteral nutrition intolerance incidence,the first time of bowel sounds,the first time exhaust and defecation and complications were compared between the two groups.Results:36 patients from 47 patients (76.60％) in the intervention group could tolerate the early feeding,while 24 patients from 46 patients (52.17％) in the control group could tolerate.There was significant difference between two groups (P ＜ 0.05).The first time of exhaust,bowel sounds and defecation,and the hospitalization time of patients in the intervention group were better than that in the conventional control group (P ＜ 0.01).Incidence rate of incision infection,pulmonary infection and intestinal obstruction in patients of the comprehensive intervention group was lower than that in the control group (P ＜ 0.05).Conclusion:Compared with the traditional treatment,the comprehensive intervention can effectively reduce the enteral nutrition intolerance incidence,promote the recovery,reduce hospitalization time and the incidence of postoperative complications,and improve the life quality of patients after surgery.

Objective To analyze the immunogenicity of selected B-cell epitopes of Epstein-Barr virus (EBV) latent membrane protein-2 (LMP2). Methods Three potential dominant B-cell epitopes of LMP2199-209, LMP2318-322 and LMP2381-391 from EBV LMP2 had been predicted using bioinformaties methods. The gene fragments of three epitopes were cloned respectively into pET32a(+) vector and transformed into E. coli strain BL21 (DE3). After identification by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting, the expression products were purified by Ni-NTA agarose affinity chromatography. BALB/c mice in immunized groups were immunized by multi-point intracutaneous injection with the three purified epitope proteins,respectively; and mice in control groups were injected with pET32a (+) protein or phosphate buffered saline(PBS), respectively. The sera from mice at week O, week 3 and week 6 of injection were collected for determination of epitope-specific antibody IgG by enzyme linked immunosorbent assay (ELISA) using epitope proteins as coating antigens. The ability of serum antibody recognizing nature EBV antigen was determined at week 6 of immunization. Results Three epitope proteins of LMP2199-209 ,LMP2318-322 and LMP2381-391 were successfully expressed in prokaryotic system. Epitopespecific antibodies IgG could be detected respectively in the sera of all immunized mice, and the levels of antibodies increased with immunized time increasing. The antibody levels in LMP2318-322 immunized group at week 3 and week 6 were significantly higher than that of pET32a (+) protein control group (F= 493.85 and 773.99, respectively; both P＜0. 05), and the antibody levels in LMP2381-391 immunized group at week 3 and week 6 were also significantly higher than that of pET32a (+) protein control group (F= 926.33 and 309.14, respectively; both P＜0.05). Antibody level in LMP2199-209 immunized group at week 6 was significantly higher than that of pET32a ( + ) protein control group (F=87.27, P＜0.05). The antibody IgG in serum from immunized mice with three epitope proteins could all recognize nature EBV antigens, especially LMP2199-209 and LMP2381-391 immunized groups.Conclusions Three possible dominant epitopes of LMP2199-209, LMP2318-322 and LMP2381-391 from EBV LMP2 are prepared by prokaryotic expression system and exhibit obvious immunogenicity, which could be used for further research of EBV infection and related tumor vaccine.

The quantity and quality of the papers cited by SCI are key standards that measure the level of basic research,academic status and teaching quality of a university.In this paper,we studied on the papers cited by SCI by statistical analysis and comparative methods in 30 well-known Chinese and foreign medical universities from 2001 to 2005.The research result showed that there is some disparity in the scale and condition of the scientific research and the technical level among Chinese medical universities and foreign medical universities.Meanwhile,it Was suggested that how to improve the quantity and quality of the papers cited by SCI in Chinese medical universities.

Objective To study the radiosensitizing effect of nano-gold nano-silver particles in hepatocellular carcinoma cells (HepG2) in vitro and the possible mechanisms.Methods MTT assay and clonogenic assay were performed to determine the killing effect of nano-gold and nano-silver particles in HepG2 cells.Flow-cytometry was used to measure cell apoptosis and cell cycle distribution.Western blotting was used to measure the expression of Caspase-3,Bax and Bcl-2.ELIASA was used to determine the content of catalase (CAT),superoxide dismutase (SOD),and total glutathione (GSH).Results Nano-gold and nano-silver particles inhibited the proliferation of HepG2 cells with IC50 of 6.51 μg/ml and 2.47 μg/ml,respectively.Nano-gold and nano-silver particles significantly enhanced the radiosensitivity of HepG2 cells.Obtained by Dq,the SER of 1/5 IC50 nano-gold and nano-silver particles were 1.37 and 1.48,and 1/10IC50 with 1.11 and 1.09.Nano-gold and nano-silver particles increased the expression of Caspase-3 and Bax and reduced the exprcssion of Bcl-2.CAT,SOD and total GSH were significantly reduced.Conclusions Nano-gold and nano-silver particles can enhance the radiation sensitivity of HepG2 cells.Specific sensitizing mechanism may be the activation of the mitochondrial apoptosis pathway and the induction of reactive oxygen species in apoptotic pathways,which ultimately induces apoptosis.

Objective To explore the value of coronary flow reserve(CFR) evaluating myocardial ischemia measured by adenosine triphosphate (ATP) stress transthoracic Doppler echocardiography (TTDE),and the feasibility of CFR to predict coronary stenosis.Methods Fifty-four patients suffering chest pain with known or suspected coronary artery disease were performed ATP stress TTDE to measure resting and maximum expansion coronary blood flow velocity and calculate CFR.all patients were performed by coronary angiography (CAG) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging.Results ① To evaluate myocardial ischemia,there was not statistical significant difference between non-invasive CFR and SPECT myocardial perfusion imaging(P ＞0.05).CFR≤2.0 was the best cutoff value for evaluating myocardial ischemia which yielded a sensitivity of 93.3 ％ and specificity of 89.7％.②Coronary artery stenosis was negatively correlated with CFR (P ＜0.001).ROC curve analysis demonstrated that CFR≤ 1.60 yielded a sensitivity of 92.3％ and specificity of 73.3％ to predict coronary stenosis significantly.Conclusions CFR measured by ATP stress TTDE can evaluate myocardial ischemia of coronary artery disease and predict LAD significant stenosis before CAG.Using CFR and CAG has important clinical value for choosing treatment of stable coronary artery disease.

Objective To compare blood pressure control in community hypertensive patients with different management methods.Methods Two neighborhood committees in a community of Pudong were selected as study area using cluster sampling method.A total of 5 166 residents aged ≥35 y were screened for blood pressure; the subjects with high blood pressure and had antihypertensive medication in last 6 months were included,and patients with secondary hypertension was excluded.The patients who entered community hypertension management program and got medication from community were included in community group; those who did not enter in community management program and/or not get medication from community were included in non-community group.Self-designed questionnaire was used for investigation.The medication compliance,awareness of hypertension risk factors and high blood pressure control were compared between two groups.Results Among 5 166 residents 4 763 were surveyed for hypertension with a response rate of 92.2％ and hypertension prevalence rate of 23.2％ (1 105/4 763).Among 1 012 patients with drug treatment for more than 6 months,there were 878 cases in community (86.8％) and 134 cases (13.2％) in non-community group.There were no significant differences in gender,age,education,working condition between community group and non-community group (P ＞ 0.05).44.3％ (389/878) patients in community group had a history of high blood pressure ＞ 10 y and that was 56.7％ (76/134) in non-community group (P =0.011) ; 28.6％ (251/878) patients in community group were at high risk for risk stratification and that in non-community group was 47.8％ (64/134) (P ＜0.001).The awareness of hypertension risk factors in community group and non-community group was 83.9％ and 95.5％,respectively (P ＜ 0.001).The medication compliance and blood pressure control rates in two groups were 93.2 ％ and 84.3 ％ (P ＜ 0.001),68.6％ and 51.5 ％,respectively (P ＜ 0.001).Conclusion The outcomes of hypertension management in terms of medication compliance and blood pressure control in community group are better than those in non-community group.