We present a case of subarachnoid hemorrhage induced by chronic suppurative otitis media and discuss the possible mechanism here. Chronic suppurative otitis media is a common suppurative inflammation of middle ear, which can cause sorts of extracranial and intracranial complications in the situation of lower resistance or higher virulence. However, the condition of subarachnoid haemorrhage caused by chronic suppurative otitis media is quite rare. According to this case and previously published articles, we consider that meningitis may be the main reason of subarachnoid hemorrhage induced by chronic suppurative otitis media.
Chronic Disease ; Ear, Middle ; Female ; Humans ; Meningitis ; complications ; Middle Aged ; Otitis Media, Suppurative ; complications ; Subarachnoid Hemorrhage ; complications

Objective To observe the effects of hydrocortisone on the rate of return of spontaneous circulation(ROSC)and the outcome of patients with cardiac arrest(CA)and cardiopulmonary resuscitation(CPR). Methods A cohort study was conducted,78 non-traumatic patients with CA were divided into hydrocortisone group (31 cases)and control group(47 cases). Conventional treatments were given in the two groups after admission,and additionally intravenous 100 mg hydrocortisone was given to the hydrocortisone group during resuscitation. The ROSC rate and prognosis were compared between the two groups. Multivariate logistic regression analysis was used to predict the impact factor of ROSC. Results The ROSC rate and 24-hour survival rate in the hydrocortisone group were significantly higher than those of the control group(ROSC rate:58.1% vs. 40.4%,24-hour survival rate:48.4%vs. 36.2%,both P<0.05). There were no significant differences between the hydrocortisone and the control groups in duration of CPR〔minute:17.1(6-45)vs. 15.8(7-48)〕,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in survivors(37.2±8.2 vs. 36.1±8.2),the survival rate(12.9% vs. 12.8%)and hospital discharge rate(6.4%vs. 6.4%)in 7 days. Hydrocortisone〔odds ratio(OR)=3.12,95%confidence interval(95%CI)-1.18-8.29, P=0.017〕and witness(OR=4.24, 95%CI -1.87-12.43,P=0.008) were independent predictors for an increased ROSC rate after multiple logistic regression analysis. Conclusion Giving hydrocortisone during resuscitation may increase ROSC rate in CA patients.

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

Objective: To establish a new method and limit of detection for Flavonoids content in Fructus Crataegi. Methods: Flavonoids in Fructus Crataegi in 10 regions was determined by colorimetry. Results: Content of Flavonoids in samples selected from 10 regions ranged 0.84%～3.62%. Content of hyperoside by colorimetry is correlative to that by HPLC. Conclusion: The method is simple, quick and reproducible. Flavonoid content in Fructus Crataegi was designed no less than 1.0%, extraction must be performed under 60?C and dried to constant weight for 6 hours.

Objective To study methods and effect of granule bone grafting into the vertebral pedicle pyramid under endoscope for treatment of thoracolumbar fractures. Methods There were 26 cases (7 males and 19 females; age range of 32 79 years, average 51.2 years) with thoracolumbar fractures. The fractures included 8 cases (30.8%) of thoracolumbar compression burst fractures with no compression of the spinal cord by broken bone fragments and 18 (69.2%) compression fractures due to senile osteoporosis. Posterior to a preliminary reduction of the lumbar region on the operating table, all cases underwent vaginal vertebral pedicle reduction under endoscope and autogenous or hererogeneous granule bone graft in order to restore the height of the fractured vertebra pyramid. The patients kept in bed for two months postoperatively; meanwhile, the excise for the back muscle was performed. Results The mean follow up period was 3 18 months. Twenty one cases (80.8%) got excellent therapeutic result, four (15.4%) moderate and one (3.8%) poor. (1) The vertebral height recovered average 29%, with mean height loss of 5% through six month follow up. (2) The posterior convex cobb angle of the spine recovered for 10? 20? (mean 13.8?). (3) No lumbago or nerve compression symptoms were found in 21 cases. Conclusions Granule bone graft into vertebra pyramid under endoscope in the treatment of thoracolumbar fractures is a minimally invasive procedure that can enhance the bone capacity of the vertebra, alleviate pain, restore the height of the fractured vertebra pyramid and accelerate bone healing.

Objective To elucidate the roles of high mobility group box-1 protein (HMGB1) and myeloperoxidase (MPO) deficiency in evaluating coronary stenosis and the vulnerability of atherosclerotic plaques in patients with coronary heart disease.Methods Totally 50 patients with acute myocardial infarction (AMI),50 patients with unstable angina pectoris (UAP),50 patients with stable angina pectoris (SAP) and 30 patients without coronary heart disease underwent the study.Coronary arteriography (CAG) and intravascular ultrasound (IVUS) were performed to analyze coronary stenosis and plaque characteristics and then gensini score was calculated.Concentrations of HMGB1,MPO and hypersensitive C reactive protein (hsC-RP) were measured by means of enzymelinked-immonosorbent assay (ELISA).Results Concentrations of HMGB1,MPO and hsC-RP were significantly higher in AMI and UAP patients than in SAP paticnts (all P＜ 0.01).IVUS showed that 51.3 ％ (20/39) AMI patients,46.7％ (43/92) UAP patients had soft lipid-rich plaqucs,while 52.9％(46/87) SAP patients had fibrous plaques,only 17.2％(15/87) had soft plaques.AMI and UAP patients had larger plaque burden and vascular remodeling index than did the SAP patients (both P＜0.01).In AMI group,HMGB1 and MPO levels were correlated well with gensini score and remodeling index measured by IVUS,respectively(r=0.54,0.48,allP＜0.05),while in UAP group,HMGB1 and MPO levels were correlated well with gensini score and plaque burden measured by IVUS,respectively(r=0.43,0.56,all P＜0.05).Conclusions HMGB1 and MPO are positively correlated with coronary stenosis,which can be used to predict the severity of ACS.HMGB1 and MPO are associated closely with plaque vulnerability and rupture.

Objective To compare the difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children diagnosed with mental retardation(MR) or borderline intellectual funcition(BIF).Methods 80 children aged 6-16 years were enrolled in this study.All of them were diagnosed with MR or BIF based on the criteria of DSM-Ⅳ-R.Then,C-WISC and WISC-Ⅳ were used to measure the IQ.Results There was no significant difference in the scores of full IQ between C-WISC and WISC-Ⅳ in these children ((65.49±12.83) vs (64.86±10.10),t=-0.591,P＞0.05).The score of verbal intelligence quotient in the C-WISC was significantly lower than the corresponding score in the WISC-Ⅳ ((64.96± 13.14) vs (68.26 ± 10.99),t=3.029,P＜0.05).The score of performance intelligence quotient in the C-WISC was significantly higher than the corresponding score in the WISC-Ⅳ ((72.48±14.04) vs (69.35±11.75),t=-2.488,P＜0.05).The scores of similarities,coding,and block design in the C-WISC were significantly higher than the corresponding score in the WISC-Ⅳ (P＜0.05)).There was no significant difference in the scores of comprehension and digit span between the two methods (P＞0.05).There was also no significant difference in MR hierarchical diagnosis between the two methods (x2=0.427,P9＞0.05).Conclusion There is no significant difference between C-WISC and WISC-Ⅳ in the diagnosis of IQ in the children aged 6-16 years who were diagnosed with MR or BIF.Both C-WISC and WISC-Ⅳ can be used to diagnose the MR and marginal intelligence for the children aged 6-16 years.

Objective To observe the expression of ITF in colon of mice infected by mouse cytomegalovirus (MCMV) and the in-volvement of ganciclovir(GCV) .Methods Forty-eight BALB/c young mice were randomly divided into blank group ,virus group and GCV group ,each with 8 mice .Mice in virus group and GCV group received injection of 100 μL MCMV virus suspension (TCID50105 .31 /mL) ,and GCV group was given intraperitoneal injection of GCV once a day at the dose of 50 mg/kg from day 0 (24 hours after vaccination of virus ) ,for 14 days .At the same time the virus group and blank group were given the same dose of normal saline as controls .Murine cytomegalovirus loads in livers and colons were measured by PCR .The expression levels of ITF in mRNA in colon were detected by RT-PCR .Results After MCMV injection ,mice in virus group manifested aggressively apparent poor appetite ,less activity ,fur laxly ,unresponsiveness to stimuli ,growth retardation ,body weight not increased .All liver and colon tissue MCMV-DNA PCR electrophoresis of virus group had positive strip ,while the blank group did not .GCV group also showed less bright positive strip when compared with the virus group .Expression level of ITF mRNA was significant higher in GCV group than virus group ,there was statistically significant difference(P<0 .05) .Expression of ITF mRNA in virus group were higher than that in blank group ,there was statistical difference(P<0 .05) .Conclusion ITF is regarded as a fast reaction peptide in the course of mucosa impairments ,so ITF plays a protective role in delayed healing process after acute MCMV infection .

Objective To identify the mechanisms of oral administered rapamycin on the prevention of restenosis after stent implantation with intravascular ultrasound (IVUS) and pathology.Methods Twenty-four New Zealand white rabbits underwent balloon-induced abdominal aortic wall injury and were given a diet of 1 ％ cholesterol for 8 weeks.Then,the rabbits were divided into three groups:the bare metal stent group(BMS group),the bare metal stent with oral rapamycin group(BMS + RAPA group) and the rapamycin eluting stent group(DES group).Rabbits in the RAPA and BMS + RAPA groups received a daily oral dose of rapamycin(0.5 mg/kg),whereas rabbits in the DES group received no drugs.All the rabbits were euthanized after the 4-week intervention.Serum lipids were measured.IVUS and pathologic studies were performed.The minimal luminal diameter (MLD),external elastic membrane (EEM) area,lumen area (LA),and plaque area(PA),plaque burden(PB) were measured.Mammalian target of rapamycin(mTOR) expression level was examined by immunohistochemistry.Results After the 4-week intervention,there was no significant difference of serum lipid levels among the three groups.IVUS showed that oral administration of rapamycin in the BMS + RAPA groups showed similar effects in reducing PA and PB as the DES group,which all were better than the BMS group.The BMS + RAPA and DES groups showed much more MLD and less lumen reduction,compared with the BMS group( P ＜0.05).Level of mTOR expression of the BMS + RAPA group and DES group was significantly lower than that of BMS group.Conclusions Oral administration of rapamycin demonstrates the same effect in the reduction of plaque burden and stent restenosis as the rapamycin eluting stent.Inhibition of mTOR by rapamycin involves in the stent restenosis.

Objective To investigate effects of complement C5a receptor and P38-MAPK on myocardial injury brought about by septic shock in rats. Method The early septic shock models were established by the method of cecal ligature and incision (CLI). A total of 30 Sprague-Dawley rats were randomly( random number) divided into normal control group ( n = 6 ) and model group ( n = 24 ) and the model group was further 12 hours later divided into 12 h subgroup (n = 12) and 24 h subgroup (n = 12). The arterial blood samples were collected 12 hours later for detecting the levels of lactate dehydrogenase (LDH) and creatine kinase (CK), and then the rats were sacrificed and the myocardial tissues were taken to assay the expressions of C5a receptor and P38-MAPK by using immunohistochemistry after HE staining. And the above procedure as did in 12 h subgroup was done 24 hours later. Results Compared with the control group, the levels of LDH and CK in rats of Model group were significantly higher (P ＜ 0. 05). There were significant differences in LDH and CK between 24 h subgroup and 12 h subgroup [(2 568.9 ± 280) vs. (2 201.2 ± 149)] and [(5 029.7±458) vs. (2 629.4±140)] ,P＜0. 05, P＜0.05. The analysis of C5aR and P38-MAPK gray values showed that there were significant differences between the model group and normal control group [(702.77 ±122) vs. (388.36±113)], P＜0. 05 and [(646.40±181) vs. (307.32 ±61)] ,P＜0.05,and those differences also found between the 24 h subgroup and 12 h subgroup. There was a significant positive correlation between C5aR and P38-MAPK (P＜0.05 ), and also the P38-MAPK had significant positive relationships with LDH(P＜0.05) and CK (P＜0.05). Conclusions The C5aR strongly potentiates the P38-MAPK to induce myocardial injury by septic shock.