Cochlear implantation has gradually been accepted as an effective treatment for many patients with severe to pround sensorineural hearing loss. The traditional cochlear implantation does not exist up to expectations in some respects. With the soft surgery technique brought forward, the idea of minimally invasive cochlear implantation is deely rooted among the people. Now many institutions are carring out a series of clinical researches and practices to improve the results of cochlear implantation surgery and reduce the complications around the world. It includes minimally invasive approach, cochleostomy and electrode insertion techniques, especially the latter two affect the preservation of residual hearing. This article is a review of the advances in minimally invasive cochlear implantation from the above three aspects.
Cochlear Implantation ; methods ; Cochlear Implants ; Electrodes, Implanted ; Hearing ; Humans ; Minimally Invasive Surgical Procedures ; methods

Objective To study whether or not CD40 gene is a target of miR-503 in U937 cells,and to observe the regulatory effects of miR-503 on expression of CD40 induced by irradiation in U937cells.Methods The miR-503 sequence was inserted into pcDNA-DEST-47 plasmid to construct the eukaryotic expression vector (pcDNA-DEST-miR-503) and to construct the CD40 gene 3′-UTR luciferase reporter plasmid (psiCHECK2-CD40) at the same time.They were used to transfect U937 cells together for analysis of the regulatory effects of miR-503 on the expression of CD40.Meanwhile the miR-203 and miR-29b were used as controls to observe whether or not CD40 gene was a target of miR-503.The expression change of CD40 after irradiation,and the inhibitory effect of miR-503 on the expression of CD40 was confirmed by Western blot assay.The expression of miR-503 was detected by real-time RT-PCR (qPCR) after irradiation with doses of 5.0 Gy.Results The expression of luciferase in the group of transfected with pcDNA-DEST-miR-503 and psiCHECK2-CD40 plasmids was significantly lower than that in the group transfected with empty plasmid and CD40 gene (t =3.16,P ＜ 0.05).And the miR-203 and miR-29b could not inhibit the activity of CD40 luciferase,but the miR-503 could significantly inhibit the activity of it (t =5.25,P ＜ 0.01 ).The expression of CD40 protein in U937 cells was decreased after the cells were transfected with pcDNA-DEST-miR-503.After irradiation with dose of 5.0 Gy,the expression of miR-503 were increased (t =3.63 - 17.00,P ＜0.01 ) and the expression of CD40 protein decreased.Conclusions The CD40 gene might be the target of miR-503,and miR-503 could regulate the expression of CD40 gene.Irradiation could up-regulate the expression of miR-503 and inhibit the expression of CD40 protein in U937 cells.miR-503 might play a role in the process of regulation of irradiation on expression of CD40 protein in tumor cells.

Tissue engineering may allow obtaining patient’s own cells, seeding them on biodegradable scaffolds, thus achieving formation of a particular tissue or organs, such as bone, cartilage, muscle, or heart. These tissues or organs can be used to repair tissue or organs defects caused by disease or trauma. Many animal studies have demonstrated the efficacy of using bone marrow mesenchymal stem cells in treatment of diseases such as nervous system diseases, liver disease, respiratory diseases and kidney disease. The main ways of the stem cells therapy are local implantation and systemic transplantation of bone marrow mesenchymal stem cells, and the effect of such treatments is notable. The use of gene-modified stem cells in gene therapy is an fantastic option due to theoretical advantage of stem cells compared to somatic cells with respect to higher proliferative capacity. Bone marrow mesenchymal stem cells can deliver genes and proteins into organs or tissues with specific need for gene therapy.

BACKGROUND:It has been demonstrated that shortening of femoral eccentricity would lead to decreased abductor muscle strength,and overlengthening eccentricity would increase the risk of femoral neck prosthesis fracture and the compressive stress of cemented femoral stem prosthesis after artificial hip replacement,which easily causes prosthetic loosening and subsidence.OBJECTIVE:To investigate the importance of eccentricity adjustment in the artificial hip replacement for treatment of femoral neck fracture in elderly patients.DESIGN,TIME AND SETTING:An observational study was performed at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2004 and December 2005.PARTICIPANTS:A total of 30 patients with femoral neck fracture,12 males and 18 females,averaging 73.8 years of age (range 62-90 years old),received treatment at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and were recruited into this study.METHODS:All patients underwent artificial hip replacement operated by the same team of surgeons.Prior to surgery,some indices on the uninjured side were determined through the anteroposterior radiographs of pelvis using X-Caliper measurement tool,including rotation center of femoral head,rotation center of hip joint,collodiaphyseal angle,femoral transverse eccentricity,abduction moment arm,and moment arm of gravity.These indices were precisely calculated using trigonometric function.The angle of osteotomy plane was determined.Proper prosthesis was selected and eccentricity was adjusted.Following artificial hip placement,a comparison was made between uninjured and injured sides.MAIN OUTCOME MEASURES:Eccentricity and hip joint function.RESULTS:The eccentricity on uninjured side of 30 patients averaged 38.7 mm (range 22-57 mm) prior to surgery and that on the injured side averaged 39.2 mm (range 21-59 mm) after surgery.Limb discrepancy ranged 1.8-8.7 mm,with a mean of 3.4 mm,after surgery.There were 26 patients (86.7%) presenting long limbs and 4 patients (13.3%) showing short limbs after surgery.All patients were followed-up 0.5-2.5 years old.Harris hip score results were excellent in 10 patients,good in 19 patients,and fair in 1 patient,with an excellent and good rate of 97%.CONCLUSION:In treatment of femoral neck fracture,eccentricity adjustment during artificial hip replacement is closely associated with hip joint function after surgery.

Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of ⅡA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system (Depuy). The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months (ranging 4.5-36.0 months), postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had tow-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°-110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.

Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.

Objective To study the killing effect of cytokine-induced killer cells (CIK cells) on human lung adenocarcinoma cell line (A549) and the lung adenocarcinoma' s radiation resistant cell line (A549RR).Methods Peripheral blood mononuclear cells (PBMC) of healthy volunteers were stimulated by different cytokines,and were induced into killer activity CIK cells.The phenotype of CIK cells were analyzed by flow cytometer.A549 and A549RR cell lines were cultured separately with the CIK cells.The absorbance value (A) of the cells was measured by CCK8,and the killing rates of all cells which were cultured for 24 and 48 hours with the CIK were calculated.Results The rate of CD3+ CD56+ cell was 45.8 ％ after culture for 14 d.The killing rates of CIK cells to lung adenocarcinoma A549 cells and its radiation resistant cells A549RR were increased with the rise of the ratio of effective cells to target (5∶1-40∶1) and the increasing of culturing time (all P ＜ 0.001).The killing effect of CIK to A549 and A549RR cells had no obvious difference in the same culturing time and the same ratio of effective cells to target(all P ＞ 0.05).Conclusion CIK cells have strong anti-tumor effect against lung adenocarcinoma and its radiation resistant cells with high clinical application value.

Setting up the innovative and entrepreneurship education and teaching system is the important content of the current university education reform. Through the idea of leading innovation with entrepreneurial practice, we have implemented a series of education reforms in the students of medical laboratory technology, reformed the teaching methods and content, set up the tutors for undergraduates and improved the scientific research ability of students. The results show that the education reforms have enhanced the ability and sense of innovation, providing a good reference for the reform of innovation and entrepreneurship education in medical laboratory technology.

OBJECTIVE: To study clinical characteristics, diagnosis, pathological types and therapy methods of nonsquamous cell neoplasm in subglottis, in order to improve comprehension of this rare disease. METHOD: To analysis 3 patients' clinical data with noosquamous cell neoplasm in subglottis by reviewing related literature, and to generalize the symptoms, differentiation and treatment experience of nonsquamous cell neoplasm in subglottis. RESULT: Among the 3 patients, one's main complain was hoarseness and the other two's main symptom was inspiratory dyspnea. As diagnosis was definite and acute obstruction of airway was relieved, the neoplasms were removed totally. Two patients were undergone operation through oral cavity by using suspended laryngoscope, and one patient was done surgery by neck approach. Paraffin wax result showed that one patient suffered epithelial-myoepithelial carcinoma, who received radiotherapy after surgery. There is no recurrence in all patients by following up more than 1 year. CONCLUSION The occurrence of nonsquamous cell neoplasm in subglottis is relatively low, and the subglottis should be inspected carefully to avoid missed diagnosis. Operation is the preferred method to treat this kind of disease. To choose a suitable operational manner according to size, location of the neoplasm is crucial.
Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; surgery ; Male ; Middle Aged

Objective To explore the clinical value of wave intensity(WI) in assessing left ventricular systolic function of patients with impaired glucose regulation.Methods 72 people were involved in this study,according to their plasma glucose levels,subjects were categorized as normal plasma glucose group (group A),newly categorized impaired fasting glucose group (group B) and pre-diabetes group (group C).Carotid WI examination was performed and analyzed.The parameters included magnitude of the peak during early systole (W1),amplitude of the peak during late systole (W2),interval between R wave of electrocardiogram and W1 (R-W1),interval between W1 and W2 (W1-W2),stiffness parameter (β),pressure strain elasticity modulus(Ep) and arterial compliance(AC).Echocardiographic indices including left ventricular ejection fraction (LVEF),left ventricular fraction shortening (LVFS) and the peak velocity of mitral annulus at systolic phase(Sm) were determined in each subject.Results Compared to group A,W1,W2,β,Ep increased significantly while AC decreased in group C(P ＜0.05).However,this difference did not persist in group B.Compared to group A,LVEF and LVFS were not observed significantly different in group B and group C.Conclusions WI is a hemodynamic method which not only can evaluate left ventricular systolic function of impaired glucose regulation subjects but also be more sensitive than routine echocardiography.