OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

Objective:To seek the short term standardization study nurses training education content and the ap-proach to learning, provide theoretical basis for improving the study effect of nurse training.Methods:Choosing 3 ~6 months in 2014 in our hospital study questionnaire survey was conducted among 114 nurses, questionnaire by general in-formation, content of training needs, demand method of three parts and using SPSS19.0 to analyze the collected data. Results:The 82.7%of study nurses think pre-service training is very necessary.Pre-service training demand of the top three comprises:occupational protection (82.7%), health care, with communication skills (80.0%) and infection prevention and control (78.2%).Refresher training needs during the top three in turn:specialized rescue of critically ill patients and cooperation (88.2%), clinical application and nursing adverse event processing (79.1%), effective communication nurses and patients (79.1%).Demand content score between the different degree and the title of ad-vanced nurse was statistically difference (P<0.05).The training methods, in the first three order practice (89.10%), seminar (74.5%), case analysis and discussion (67.30%).Conclusion:According to the study demand of nurse stand-ardized training content and ways of learning, considering the influence factors such as education, job title, targeted training plan, improve the effect of short-term training.

Objective:To explore the role of peripheral blood monocyte subsets in the pathogenesis of rheumatoid arthritis (RA),we therefore decided to compare the percentage of monocyte subpopulations in peripheral blood,as well as cytokines secretion function,to that of healthy controls. Methods:22 patients with RA and 22 cases of healthy controls ( HC) were drew 3 ml fresh venous blood into a tube containing heparin. The percentage of monocyte subsets,expression of Toll-like receptor(TLR)2,HLA-DR,triggering receptor expressed on myeloid cells-1(TREM-1) on intermediate monocyte and mean fluorescence intensity(MFI) of intracellular tumor necrosis factor-α ( TNF-α) were evaluated with the methods of flow cytometry ( FCM ) . The correlation between percentage of monocyte subsets and serum cytokines was explored. Statistical significance between parametric data was determined by the students't-test. Results:Compared to HC controls, the percentages of intermediate monocytes were significant higher in RA patients [ ( 11. 7 ± 1. 6)% vs (4. 6±1. 2)%,P<0. 05],as well as the expression(MFI) of TLR2 (750. 2±110. 3 vs 526. 8±98. 6) and TREM-1 (58. 4± 12. 1 vs 40. 3±10. 2) on intermediate monocytes (P<0. 05). The expression of HLA-DR on intermediate monocytes of RA patients had no difference with HC controls (P>0. 05),while MFI of intracellular TNF-αin intermediate monocytes of RA patients were significant higher than that of HC controls (46. 3±6. 4 vs 36. 7±8. 3,P<0. 05). In addition,RA patients showed a positive correlation between the percentage of CD14highCD16+ monocytes and DAS28 scores(r=0. 538,P=0. 009),as well as the serum levels of TNF-α,IL-17 ( r=0. 471,P=0. 027;r=0. 593,P=0. 003). Conclusion:Monocyte subpopulations from RA patients are abnormally skewed toward to in-termediate monocytes which has high expression of TLR2 , TREM-1 and the function of TNF-α secretion. Therefore, intermediate monocytes may play a role in the pathophysiology of RA. By modulating polarization or blocking monocyte cell surface receptors could be a new treatment of RA.

0.05],significantly higher than stage Ⅲ,Ⅳ[60%(6/10),50%(5/10);P

CardiovascuIar disease is the number one cause for morbidity and mortaIity worIdwide. Possi-biIities for new therapies in the emerging fieId of cardiac signaIIing prompted extensive research on myocardiaI re-modeIIing over the past decades. In this review,we as-sembIe an overview of the recent findings on the muIti-functionaI enzyme,p21-activated kinase 1( Pak1),a member of a serine/ threonine protein kinase famiIy in the heart,particuIarIy its cardiac protective effects. We pres-ent a modeI for Pak1 signaIing that provides a mecha-nism for specificaIIy affecting cardiac ceIIuIar processes. We discuss its cardiac protective effects such as anti-hy-pertrophy,anti-ischaemic injury and roIe in maintaining ventricuIar Ca2+ homeostasis and eIectrophysioIogicaI stabiIity under physioIogicaI, β-adrenergic and hyper-trophic stress conditions.We aIso discuss the potentiaIs of Pak1 activation by naturaIIy occurring sphingosine and its anaIogues FTY720,and bioactive peptides designed to diminish Pak1 auto-inhibition as noveI thera-peutics for major cardiovascuIar diseases.

Alveolitis, Extrinsic Allergic ; diagnosis ; therapy ; Humans ; Occupational Diseases ; diagnosis ; therapy

Adult ; Branchio-Oto-Renal Syndrome ; diagnosis ; Child, Preschool ; Craniofacial Abnormalities ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Male

15mm~2)of dural sac cross-sectional area to values smaller than 75 mm~2 was found during examination in axial loading,or if a suspected disc herniation,narrow lateral recess,narrow intervertebral foramen,or intraspinal synovial cyst changed to being obvious at the axial loading examination,they were regarded as additional information.Results After axial loading CT examination,AVI was found in 16 of 40 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation was more severe in 7 patients,lateral recess or interverbral foramen narrowed in 4 patients,no intraspinal synovial cyst was found.After axial loading MRI examination,AVI was found in 19 of 60 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation became severe in 10 patients,lateral recess or interverbral foramen narrowed in 8 patients,no intraspinal synovial cyst was found.AVI was found in 32 of 79(40.5%)patients with sciatica and 2 of 20(10.0%)patients with low back pain(?~2=7.45 P

Objective To probe the influence of electron beam radiotherapy in different manners using different tissue equivalent boluses on skin and lung.Methods Adult female cavia cobayas were randomly divided into four groups as control group,fuU-time with bolus group,half-time with bolus group and without bolus group.Acute-irradiation animal models were established using electron beam in different manners with or without 0.5 cm tissue equivalent bolus.Pathological changes in lung,hair vesicle and fibroblast cell count were analyzed 40 clays after irradiation.Results The radiation dermatitis in the group with bolus was slighter than that of the group without bolus,but the radiation pneumonia was reverse.With bolus,the radiation dermatitis of haft-time group was slighter than that of full-time group.The injury repair of half-time group was more active than full-time group.Conclusions The treatment of haft-time bolus could protect lung without serious skin complications.

Objective To investigate the expression of c-kit and analyze its relationship with proliferating cell nuclear antigen (PCNA) in RCC subtypes and its clinical progression. Methods Expression of c-kit protein was retrospectively studied with immunohistochemistry in paraffin sections from 137 cases of clear renal cell carcinoma (CCRCC), 82 papillary renal cell carcinoma (PRCC), 51 chromophobe renal cell carcinoma (ChRCC). Results The positive rate of c-kit in ChRCC was 94.1%(48/51), it was statistically higher than that in CCRCC (16. 1%, 22/137) and PRCC (28.1 %, 23/82)(P=0. 001 ). In ChRCC, the positive expression of c-kit was related with TNM stages. The positive expression of PCNA was related with the grade in CCRCC and PRCC. But there was no relationship between PCNA expression and grade of ChRCC. It also had the relationship with the metastasis in CCRCC. Conclusions The expression of c-kit in ChRCC is higher than in other subtype of RCC, and associated with tumor local progression. That makes c-kit as a helpful marker to discriminate different subtypes of kidney cancer.