[Summary] Chronic suppurative otitis media affects patients ’ quality of life, and is life-threatening in patients with cholesteatoma which causes intracranial or extracranial complications .The purpose of surgery is to clear up all the lesions and to reconstruct hearing function .Tympanoplasty is the main surgical method , which includes basically canal wall down ( CWD) and canal wall up (CWU) styles.CWD provides lager surgical field but impairs normal auditory canal structure ; CWU preserves the posterior wall of external auditory canal and provides better quality of life although it has higher possibility of recurrence of cholesteatoma .We reviewed the surgical methods , surgical effects , recurrence rates , and surgical indications of canal wall up mastoid-tympanoplasty , hoping to provide meaningful reference for clinical application .

Dysregulation and activation of immune processes are important in age-related macular degeneration (AMD) pathogenesis.The single nucleotide polymorphism of complement factor H is widely recognized as a risk factor to AMD.Over-activation of nod-like receptor3 and polymorphism of Toll-Like Receptor 3 also associated with AMD.Except for innate immune processes,adaptive immunity also play a critical role in AMD,a growing body of evidence supports that auto-antibodies and T cells are related with AMD.Additionally A2E and lipid oxidation byproducts might also have a role in AMD pathogenesis.

Objective To evaluate the diastole asynchrony of the different segments of left ventricle(LV) and its relation with LV diastole function in the patients with hypertrophic cardiomyopathy (HCM) by quantitative tissue velocity imaging(QTVI).Methods Forteen normal controls,15 patients with non-obstructive HCM (HCM) and 12 patients with obstructive HCM (HOCM) were studied by QTVI.The regional velocity profiles of 18 segments of LV and mitral annulus of six walls along LV apical long axis view,apical two chamber view and four chamber view were obtained.The time (T_ Q-E ) from onset of QRS complexes to peak velocity during early diastole were measured.The maximal difference in T_ Q-E with in the same wall (Intra-?T_ Q-E ),the same segment (Inter-?T_ Q-E ),all 18 segments (Max-?T_ Q-E ) of LV and the mean ratio of mitral annulus early and late diastole peak velocity of six walls were calculated(Ea/Aa′).Interventricular septum basic thickness(IVSTh) and LV outflow tract gradient(LVOTPG) were measured.Results Inter-?T_ Q-E ,Intra-?T_ Q-E ,Max-?T_ Q-E were significantly prolonged and Ea/Aa′ was reduced in HCM and HOCM groups compared with control group.There was no statistically significant difference of Inter-?T_ Q-E ,Intra-?T_ Q-E ,Max-?T_ Q-E ,Ea/Aa′ between HCM and HOCM groups.In control group,HCM group,HOCM group,IVSTh and LVOTPG were increased little by little.Max-?T_ Q-E were correlated negatively with Ea/Aa′ in patients with HCM and HOCM.IVSTh and LVOTPG were mildly correlated with Ea/Aa′ in HOCM group,but not correlated with Ea/Aa′ in HCM.Conclusions Asynchrony diastole is a neccessary factor causing impairment of LV diastole function exists within the same wall and the same segment of LV in patients with HCM,but IVSTh and LVOTPG is not a neccessary factor causing impairment of LV diastole function.Asynchrony diastole in patients with HCM could be an appereance of cardiomyopathy.

Objective To evaluate the asynchrony of right ventricle(RV) and its significance in idiopathic pulmonary artery hypertension(IPAH) patients by quantitative tissue velocity imaging.Methods Twenty-five normal people,26 IPAH patients were studied.RV structure parameter(thickness of lateral wall,late diastolic and systolic area and fractional area change) and function parameter [peak systolic velocity(Sa),early diastolic velocity(Ea),late diastolic velocity of tricuspid annulus of lateral wall and Tei index] were measured and calculated.Regional velocity profiles of 6 segments of RV were obtained.The time from onset of QRS complexes to Sa and Ea(T_(Q-S),T_(Q-E)) of 6 segments were measured.The maximal difference in T_(Q-S) and T_(Q-E) in the same wall(Intra-?T_(Q-S),Intra-?T_(Q-E)),the same segment(Inter-?T_(Q-S),Inter-?T_(Q-E)) and all 6 segments(Max-?T_(Q-S),Max-?T_(Q-E)) were calculated.Results Compared with controls,Inter-?T_(Q-S),Inter-?T_(Q-E),Max-?T_(Q-S) and Max-?T_(Q-E) were significantly prolonged in IPAH patients(P(0.05)).Max-?T_(Q-S) and Max-?T_(Q-E) were correlated with structure and function parameter in IPAH patients.Conclusions Asynchrony exists in RV and have good relation with RV structure and function in IPAH patients.

Objective To study the detection and significance of human papillomaviral DNA(HPV-DNA) in cervical disease. Methods The express of HPV-DNA were detected by hybrid capture 2 in the patients with chronic cervicitis ( n = 166), cervical intraepithelial neolasia ( GIN ) ( n = 89 ) and uterine cervix cancer ( UCC ) ( n = 23 ). Results The positive expression rate of HPV-DNA in GIN Ⅰ , Ⅱ , Ⅲ grade and UCC were 70.8% (17/24) ,79. 3% (23/29) ,88.9% (32/36) ,91. 3% (21/23). They were significantly higher than those in chronic cervicitis 30.7% (51/166) (P ＜ 0. 01 );As the development of cervical disease, HPV-DNA positive expression had increasing trend.Conclusion The detection of HPV-DNA had an important role for the early UCC screening,prevention and treatment.

Comprehensive treatment is the hot for cervical carcinoma,but comprehensive treatment is not the superposition of several treatment methods.Surgical treatment is the main means for early cervical carcinoma and radiotherapy for locally advanced. It's sure that radiotherapy combined with hyperthermia.Abroad,concurrent chemotherapy and radiotherapy is regarded as routine treatment methods.Improvement of hyperthermia technology is more applicated in the clinical.Reducing complications after treatment and enhancing the effectiveness of the treatment of cervical carcinoma is the ultimate goal.

BACKGROUND: Vitapex is an injectable root canal filling material. It possesses effects of antibiosis, analgesia, as well as promotes formation of alveolar bone, dentin and cementum, which had been widely used in apexification. However, it also has weakness of long induction time and need reduplicated subsequent visit.OBJECTIVE: To explore the therapeutic effect of mineral trioxide aggregate (MTA) and Vitapex paste on apexification.DESIGN, TIME AND SETTING: The contrast observation experiment was performed at the Department of Stomatology,Shenyang Children's Hospital from February 2006 to November 2008.PARTICIPANTS: A total of 42 patients with 49 teeth were included in this study, including 28 anterior maxilla and 21 premolars.The X-ray film showed that the root tip of teeth was immature.METHODS: The teeth were randomly divided into the experimental group (n=25) and control group (n=24), which was apexificated by MTA and Vitapex paste, respectively.MAIN OUTCOME MEASURES: The effective rate of two groups was compared at months 3, 6 and 12 after operation.RESULTS: All teeth were included in the final analysis. The effective rate of experimental group was greater than the control group at 3 months after operation, and the difference had significant (P < 0.05), while, the effective rate was similar in two groups at 6 and 12 months after operation (P > 0.05).CONCLUSION: Both MTA and Vitapex paste are ideal filling materials in apexfication. Nevertheless, MTA may be a substitute in apexfication for its short therapy duration and precisely therapeutic effect.

Clinical treatment shows little significance for some terminal tumor in practice,in which case hospice care seems to be particularly important.During the application of modern nursing ethics to hospice care,some aspects should be bared in mind,including trying to meet the demand of patients and their family members,showing enough respect for their right to choose,and appropriately instructing death education.Meanwhile,communication and cooperation with other medical staff should also be stressed during hospice care.

Objectives To study the frequency and risk factors of osteoporosis,and the relationship between bone turnover makers and bone mineral density (BMD) in patients with ankylosing spondylitis (AS).Methods BMD in the spine and femoral neck was measured with dual-energy x-ray absorptiometry (DEXA) in 30 AS patients. Enzyme linked immunoassay was used to measure serum bone gla protein (BGP), bone-specific alkalin phosphtase (BAP), and urine deoxypyridinoline crosslinks (D Pyr).Results The patients in early stage lost the bone mass already.They had lower volume of BMD in both hip and spines than that of controls. But in the later stage,the BMD of spines was higher than that of the control group because of the calcification of the surrounding tissues of the spine.While even the BMD of femoral neck was still lower than that of normal subjects. Osteoporosis was observed in 6 patients, osteopenia in 10. Osteoporosis in AS correlated negatively with the disease duration, ESR, CRP, and X ray grades. The reduction in BMD in premenopausal women with early AS was slighter than that in men. The BMD had no significant differences in HLA B 27 (+) patients and HLA B 27 (-)patients. BGP and BAP which reflect bone formation had no differences in AS patients and controls. D Pyr which reflects bone resorption was significantly increased compared with controls.Conclusions Osteoporosis in AS is common and may be related to disease duration and severity. A significant increase in bone resorption is observed in AS with osteoporosis.

Objective To explore the clinical diagnostic value of CYFRA21-1 in benign lung disease deriving from epithelium cells.Methods CYFRA21-1 level in serum and hydrothorax was determined by electrochemiluminescence immunoassay. The complex sandwich (KS 19.1 monoclonal antibody-CYFRA21-1[Ru(bpy)3]2+ labeled monoclonal antibody BMI 9.21) was fixed to the bead enclosed avidin by means of biotin-avidin combination, then the luminescence under the influence of perfluorotripropylamine and electric field luminous was tested for CYFRA21-1.Results The level of CYFRA21-1 in the group suffering from lung disease accompanied by complications was significantly higher than that of single lung disease group (P<0.01). CYFRA21-1 value in the elder group was significantly higher than that of the younger group (P<0.01).Conclusion The gerontal patients suffering from benign lung disease accompanied by complications should be given symptomatic treatment if their CYFRA21-1 level is elevated but CEA and NES was normal. Recheck the above indices two weeks later so as to identify the benign or malignancy of the disease.