OBJECTIVE To investigate the feasibility of determining the maximum comfortabl level by using the acoustically evoked stapedius reflex threshold via cochlear implant. METHODS Eleve cases of Nucleus C124 cochlear implant recipients operated in our hospital were selected(8-39 years old, who can decide TIC value by themselves with the postoperative time ranging from device initiation to 1 year after operation),of those four cases were diagnosed as bilateral large vestibular aqueduct syndrome,1 case as common cavity dysplasia,.neural response telemetry of these five patients with inner ear dysplasia were very high or barely measurable.Real-MCL level and acoustically evoked stapedius reflex threshold under activated condition were measured respectively. The stimulating sound was 110dB of white noise.RESULTS The two group values of ASRT and real-MCL were found to be consistant .There is no significant difference statistically (P＞0.05). The thresholds of ASR increase with the increasing of real-MCL at the beginning of device initiation. CONCLUSION The acoustically evoked stapedius reflex threshold may reflect (ASRT) the maximum comfortable stimulation level under activated conditions in patients with cochlear implants.it is simple, reliable and may be used to determine the MCL of child cochlear implanted patients.

Objective To compare the efficacy of sequential therapy combined with probiotics,pure sequen-tial therapy and standard triple therapy for Helicobacter pylori eradication.Methods Selected the clinical data of 240 patients admitted.The 240 patients were randomly divided into 3 groups.Group A received standard triple thera-py,group B received sequential therapy and Group C received sequential therapy in combination with probiotics. Then,we compared the eradication rate,the score of gastrointestinal tract symptoms before and after treatment,and the side effects among 3 groups.Results The eradication rate was 72.5% in groupA,87.5% in group B,and 96.3% in group C.The eradication rate of group C was significantly better than group A and group B (χ2 =18.531,P <0.001).There was no difference in the score of gastrointestinal tract symptoms before treatment(F =0.206,P >0.05),but they all significantly decreased after treatment among 3 groups(P <0.05),with group C a better result(F =25.581,P <0.05).The side effects of 3 groups were 16.3%,13.8%,3.8%,respectively.There were a significantly differencec between group C and the other 2 groups(χ2 =7.011,P =0.030).Conclusion Sequential therapy in combination with probiotics can achieve a higher eradication rate,improve the score of gastrointestinal tract symptoms, and decrease side effects.

Objective To establish an animal model of high-iodine and low-protein in Wistar rats,and to observe the effect of combined excess-iodine and low-protein diet on growth,metabolism and morphological changes in thyroid.Methods According to body weight[(110 ± 10)g] and sex(half male and half female),one hundred and ninety-two Wistar rats,1 month after weaning,were randomly divided into ① normal iodine control group (NI),② 10-fold excess-iodine group (10HI),③ 50-fold excess-iodine group (50HI),④ 100-fold excess-iodine group (100HI),⑤ low-protein control group (LC),⑥ low-protein and l 0-fold excess-iodine group (L10HI),⑦low-protein and 50-fold excess-iodine group (L50HI),⑧ low-protein and 100-fold excess-iodine group(L100HI).Twenty-four rats were in each group,with the experimental period of 6 months.The iodine content of NI and LC groups was 4.65 μg/d; 10HI,50HI and 100HI groups were 46.50,232.50 and 465.00 μg/d,respectively.The animal's body weight,water and feed consumption were recorded weekly.At the end of 60,120,180 days,urine and blood samples were collected from eight rats in each group.Urinary iodine was tested by arseni cerium catalytic spectrophotometry; serum iodine was tested by the method of chloric acid.Histological change of the thyroid gland was observed by transmission electron microscopy and hematoxylin-eosin (HE) staining at the end of 6 months; apoptosis of thyroid was tested by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.Results At the end of 4,8,16,18,22 and 24 weeks,the differences of body mass of rats among groups were statistically significant(F =4.26,3.75,4.98,4.09,3.28,3.95,all P ＜ 0.05).At the end of 60,120,180 days,the differences of iodine concentration in urine and blood among groups were statistically significantly (H =5.37,6.03,all P ＜ 0.05).Light microscopy showed that thyroid follicular epithelial cells became flattened,and follicles became distended with colloid following increasing of iodine concentration.Electron microscopy showed increased glial vesicles,condensation of nuclear chromatin,karyopyknosis,and karyolysis with increasing of iodine concentration.The differences of apoptotic indexes among groups were statistically significant (F =4.59,P ＜ 0.01).The apoptotic indexes of L50HI and L100HI groups [(21.50 ± 5.20)‰,(26.70 ± 6.40)‰] were higher than those of 50HI and 100HI groups [(11.20 ± 4.30)‰,(19.40 ± 4.80)‰,P ＜ 0.01 or ＜ 0.05].Conclusion Excessiodine and low-protein can cause growth retardation,abnormal iodine metabolism,and thyroid follicular epithelium damage in Wistar rats.

OBJECTIVETo investigate the clinical effects of close reduction and minimally invasive percutaneous plate osteosynthesis in treating proximal humerus fractures in the aged.

METHODSFrom February 2012 to December 2013,39 patients with proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO group, 21 cases) and open reduction internal fixation (ORIF group, 18 cases). Including 17 males and 22 females in the study, and aged from 67 to 88 years old with an average of (71.8 ± 5.2) years old. In MIPPO group, there were 11 males and 10 females with an average age of (70.0 ± 5.3) years old;and in ORIF group, there were 10 males and 8 females with an average age of (72.0 ± 4.2) years old. Operation time, blood loss during operation, fracture healing time and postoperative complications were recorded. The functions of the shoulder joints were assessed according to Constant-Murley score at final follow-up.

RESULTSAll the patients were followed up from 11 to 27 months with an average of 18.1 months. The mean blood loss of the MIPPO group was (176.0 ± 57.4) ml,while the ORIF group was (356.0 ± 66.9) ml (t = 7.22,P = 0.01). The operation time of the MIPPO group was (47.4 ± 14.9) min, while the ORIF group was (92.7 ± 15.8) min (t = 0.79, P = 0.03). Fracture healing time in the MIPPO group and ORIF group was (17.6 ± 5.8), ( 21.7 ± 4.9) weeks, respectively (P < 0.05). The mean Constant-Murley score at final follow-up was 89.7 ± 14.5 in MIPPO group, and 81.8 ± 13.2 in ORIF group (P < 0.05).

CONCLUSIONMIPPO has advantages of little trauma, less blood loss, rapid recovery, less vascular damage and so on and can effectively treat the proximal humerus fracture in the aged.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Shoulder Fractures ; surgery

OBJECTIVE To find the best way to evaluate the hearing threshold with the objectivethresholds of auditory brainstem response(ABR) and 40Hz auditory event related potential(40Hz AERP) . METHODS Pure tone audiometry,ABR and 40Hz AERP detection were performed in 120 recipients from whom 86 ears were available to be analyzed. According to the styles of configuration of hearing,we divided the 86 ears into 3 groups. There were 37 ears in flat style group,29 ears in descent style group,20 ears in ascent style group. The values were statistically analyzed with SPSS software. Correlations and multiple linear regression analysis were used in each group separately and three kind of mathematic models were established to estimate the subjective auditory thresholds. Then the models were simplified and tested. At last the models were checked out in 10 new recipients separately. RESULTS The pure tone audiometric threshold had good liner correlations with ABR and 40Hz AERP in three groups(R2=0.932,0.944,0.934) . In the flat style group,the subjective average auditory threshold can be estimated by ABR threshold. The predict mathematic model of the descent style group was 1/3(40HzAERP) +2/3ABR and the model of the ascent style group was 2/3(40HzAERP) +1/3ABR. Mean square deviation test showed equation manners were better than ABR means. CONCLUSION We can predict the subjective average auditory threshold more accurately than ABR only from ABR threshold and 40Hz AERP values with the predict mathematic models in young child and patients difficult to be test with subjective audiometry.

Objective To investigate the relationship between the expression level of platelet membrane glycoprotein?3(GPⅢa,CD61)and the severity of disease in patients with hemorrhagic fever with renal syndrome(HFRS).Methods One hundred and four patients with HFRS and 30 healthy individuals were recruited.The percentage of CD61 positive platelets and the mean fluores- cence intensities(MFI)of platelet membrane glycoprotein?3 were determined by flow cytometry (FCM).The 104 patients studied were divided into three groups based on their expression levels of platelet membrane glycoprotein?3 at oligurie phase.Clinical data and laboratory parameters in different groups were compared and analyzed.Results The expression levels of CD61 in patients with HFRS were significantly higher than those in control group,although no significant difference in the percentage of CD61 positive platelets between patients with HFRS and controls was detected.The MFI of CD61 expression in patients with HFRS at fever phase,oliguric phase and polyuric phase was 19.75?2.57,17.46?1.48 and 15.55?0.60,respectively,which was significantly higher than that in control group(3 20?0.12).The expression level of CD61 in patients with HFRS at oliguric phase was negatively correlated with platelet count and serum albumin(r=-0.637 and-0.695,respec- tively)and positively correlated with white blood cell count,blood urea nitrogen,serum creatinine and alanine aminotransferase(r=0.945,0.904,0.956 and 0.891,respectively).When the patients were compared according to the expression levels of CD61,it was indicated that the higher the expression level of CD61,the higher the incidence of uremia,hypoalbuminemia,abnormal liver func- tion and leukocytosis.Conclusions The expression levels of platelet membrane glycoprotein?3 in patients with HFRS are different in different clinical phases and are significantly correlated with the severity of the disease in the patients.It suggests that the expression levels of platelet?3 integrin are dramatically increased in patients with HFRS,which may be an indicator for the severity of disease and be helpful for monitoring the state of the patients' diseases and evaluating the severity of the disease.

AIM: To study the effects of CIK cocultured with DC that pulsed with RCC antigen on renal carcinoma cells.METHODS: DC and CIK cells were generated respectively by cytokines from PBMC of healthy blood donor.Cell surface markers were analyzed by flow cytometry.Then CIK were cocultured with autologous DC that was(or not) pulsed with RCC antigen(786-0 cells).Cytotoxic activity against 786-0 or PC3 cells was measured by MTT assay under three different conditions: CIK cocultured with DC which was pulsed with 786-0 antigen(group A);CIK cocultured with DC which is not pulsed with 786-0 antigen(group B);CIK without DC(group C).RESULTS: The cytotoxic activity of three groups against 786-0 cells was(70.64?8.26)%,(53.40?7.33)%,(46.64?6.01)%,respectively(E/T=(20∶1)).Significant differences between group A and group B or between group A and group C were observed(P

Objective Toinvestigatetheclinicalvalueofhumanneutrophillipocalin(HNL)detectioninthedifferentialdiagnosis of bacterial and viral infections of elderly patients with acute respiratory infection .Methods 142 elderly patients with respiratory infection were divided the bacteria group (96 cases) and the virus group (46 cases) according to their infections ,42 healthy people in the corresponding period were enrolled as the control group .Enzyme-linked immunosorbent assay and highly sensitive dry chemi-cal particles enhanced immune turbidity assay were employed to detect their blood HNL and C-reactive protein(CRP) ,respectively , and virus-specific antibodies detection were performed simultaneously .Results Compared the blood HNL ,CRP levels and their positive rates of patients in bacteria group with those in the virus group ,control group ,respectively ,differences showed statistically significant(P<0 .01) ,while the differences of indicators listed above between the virus group and control group had no statistically significant(P>0 .05) .Antibiotic treatment before and 24 ,48 and 72 hours after ,the concentrations of HNL were (216 .8 ± 64 .1) , (192 .0 ± 41 .2) ,(158 .0 ± 54 .5) and (87 .0 ± 12 .4)μg/L ,respectively ,while those of CRP were (50 .9 ± 40 .9) ,(46 .2 ± 18 .3) , (39 .6 ± 9 .6) and (12 .6 ± 9 .8) mg/L ,respectively .Sensitivity ,specificity ,positive predictive value and negative predictive value of HNL detection were 90 .6% ,90 .9% ,91 .5% and 89 .9% ,respectively ,which were higher than those of CRP (88 .5% ,85 .2% , 86 .7% and 87 .2% ,respectively) ,with statistically significant difference(P<0 .05) .Conclusion NHL detection possesses impor-tant significance in differential diagnosis between bacterial and viral infections of elderly patients with acute respiratory infection .

Objective Innovate scientific research management thinking,explore new scientific research management models,and enhance hospital's competitiveness.Methods The hospital insistently adheres to the path of science and education hospital development in the practice of scientific research management,and takes measures of creating academic atmosphere,innovating management concept,rationalizing incentive measures,setting supporting policies,and so on.Results The hospital has gained certain progress in the fields of key discipline construction,research project,talent plan,scientific and technological achievements,etc.Conclusions The path of science and education hospital development plays an important role in the further healthy and sustainable development of hospital.

Objective To summarize the common types and clinical characteristics of ureter disease;which can increase manipulation difficulties and adverse events during rigid ureteroscopic procedures. Methods From Jan 2001 to Dec 2010,our team performed 317 rigid ureteroscopic Drocedures for ureteroscopic examination or treatment;including 60 difficult procedures(34 male and 26 female).The mean age of the patients was 37 years (range,18 to 71).The ureteral diseases were classifted into five types according to the pathological characteristics:Type Ⅰ calculous stenosis,Type Ⅱ neoplastic stenosis;Type Ⅲ non-congenital stenosis,Type Ⅳ congenital stenosis,Type Ⅴ expansion of tortuous ureters.The operative time,complications,and conversion to open surgery were evaluated,and the therapeutic methods were analyzed. Results Of the 60 difficuhly-manipulated procedures,the mean manipulated time was 75 min (range,31 to 200).Intra-operative complications occurred in 9 procedures,including 4 cases of mucosal bleeding,2 cases of submucosaI false passage and 3 cases of ureteral perforation.Eleven procedures were converted to open surgery. In five procedures only a double J tube was inserted for drainage due to the difficulty of entering the ureter.Fiftyfive patients were followed up for 17 months (range,3 to 110);48 patients were cured,5 patients improved and 2 patients were unchanged. Conclusions The five types of ureteral disease can increase operative difficulties and risks of rigid ureteroscopic procedures.We should be cautious during surgery and should stop manipulation or convert to other surgeries if necessary.