Heart Septal Defects, Atrial ; complications ; Humans ; Infant, Newborn ; Male ; Nasal Polyps ; complications ; congenital ; Nasopharyngeal Diseases ; complications ; congenital

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 explore the diagnosis,treatment and prognosis of primary gastric malignant (lymphoma)(PGML).Methods The diagnosis and treatment data of 21 cases of PGML admitted in our(hospital) during 8 years was retrospectively analyzed.The diagnostic methods included barium meal(examination),gastroscopy,B type ultrasonography,and CT scan.All patients underwent operative treatment and most of the patients received adjuvant chemotherapy.Results Upper abdominal pain,digestive tract bleeding,emaciation and abdominal mass were common clinical manifestations of PGML.The resectabilty rate of PGML was 90.5% while the 5-year survival rate was 57.1%.Conclusions The key to a satisfactory prognosis was early diagnosis,radical curative operation and combined treatment.

Background Treatment of corneal ulceration by transplanting drug-loaded amniotic membrane has been used widespreadly abroad,however,seldom study is found in China up to now.Objective This study was to explore the sustained release property and the efficacy of the drug-loaded amniotic membrane.Methods The bacteriostatic area of amniotic membrane fragments immersed with different concentrations (5,20,30 g/L) of levofloxacin for different time points (5,15,30,60 minutes) was evaluated by in vitro test.Bacterial corneal ulceration models were established in 20 rabbits by injected 0.7 MCF staphylococcus aureus suspension (0.1 ml) into the central corneal stroma to form the cloudy area of 4.0-6.0 mm.Then the rabbits were randomized into two groups.Regular amniotic membrane transplantation was performed laterally and 0.5％ levofloxacin drops was topically administered after operation in the amnion+levofloxacin drops group,and drug-loading amnion transplantation was used in the drug-loading amnion group.Aqueous humor of 0.1 ml was collected in 30 minutes,1 hour,2,3.5,5.5 hours after levofloxacin was administered and 1 day,3,7,10,14,21 days after operation for the detect of levofloxacin level with high-performance liquid chromatography.The corneal symptom was scored based on McNeill's criteria in 1 week,2 weeks and 4 weeks and the ulceration area was assessed under the slit lamp in the first week.The pathological examination was carried out in the fourth week after surgery.Results The mean bacteriostatic area was bigger with the increase of levofloxacin concentration,and bacteriostatic area in amnion immersed for 15 minutes was bigger than that of 5 minutes (P＜0.01).The levofloxacin concentration of aqueous humor after transplantation was decreased by extending the time,and that in 30 minutes and 5.5 hours after operation was (0.873±0.264) mg/L and (0.106±0.027) mg/L,respectively,in the amnion+levofloxacin drops group,and that in day 1,3,7 after surgery in the drug-loading amnion group was higher than at 30 minutes in the amnion+levofloxacin drops group,showing all significant differences (all P =0.00).In the first,second and fourth week after operation,the corneal symptom score was 1.7±0.6,1.3±0.5,0.2±0.4 in the drug-loading amnion group and 2.2±0.8,2.0±0.6,1.5±0.8 in the amnion+ levofloxacin drops group,with the significant differences among the different groups and time points (Fgroup =9.49,P =0.01 ;Ftime =22.96,P=0.01).The corneal ulceration area was (1.6±0.6) mm2 in the drug-loading amnion group and (3.2±0.8) mm2 in the amnion+levofloxacin drops group 1 week after operation,showing a significant difference between them (t =3.98,P =0.00).Histopathological revealed that the various layers of cornea tissue appeared irregular arrangement in the amnion + levofloxacin drops group 4 weeks after operation with 1-2 layers of new squamous epithelium.Disorder hypothallus structure,more inflammatory cells and residual vascular cavity were visible.However,new squamous epithelium of 4-5 layers was seen in the drug-loading amnion group,and inflammatory cells and residual vascular cavity were less than the amnion+levofloxacin drops group 4 weeks after operation.Conclusions Levofloxacin-loaded amniotic membrane can sustained release levofloxacin and maintain an effective drug concentration in aqueous humor,which improves the treating efficacy for staphylococcus aureus corneal ulceration.

OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P<0.05). There was no statistical significance in the proportion of patients with unreasonable drug choice,unreasonable initial prophylactic medication tim-ing and unreasonable drug combination,the proportion of different antibiotics types,average hospitalization cost and average drug cost(P>0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.

Objective To establish the early warning model for apostasis of postoperative patients with cerebral tumor, predict the risk of apostasis, so as to realize the early control and prevention. Methods Nine hundreds and ninety-five cerebral tumor patients were enrolled in a prospective investigation, the clinical data were collected and analyzed to make the early warning model by Logistic regression analysis. Results Collected 995 valid questionnaires, 149 cases(15.6%, 149/995) need unplanned transfer to ICU, 50 cases(5.0%, 59/995) need unscheduled second operation. The early warning model was established by Logistic regression analysis based on pupil, Glasgow Coma Scale(GCS) score, Modified Early Warning Score(MEWS) three indicators associated with disease progression:Z=0.1×pupil+0.8× GCS score+2.5×MEWS.Then the effectiveness of the model was verified by ROC curve, and the results showed that the area under the curve was 0.852(95%CI 0.816-0.887), sensitivity was 80.5%, specificity was 80.5%, accuracy was 85.0%, Youden index was 0.61, positive likelihood was 4.128, negative likelihood was 0.242. Conclusions The early warning model can predict the apostasis events of postoperative patients with cerebral tumor, also can prevent the complications and improve the quality life of patients.

To investigate the effect of the anti-endotoxic part of Radix Isatidis on the expression of moesin mRNA in murine tissues induced by lipopolysaccharide (LPS), the sample solution of F(022) part from Radix Isatidis was intraperitoneally administered to experimental mice, and the lipopoly-saccharide (LPS) were injected into the tail vein, and then the tissues of liver, kidney and spleen were colleted and cut into slices. The mRNA was detected by moesin mRNA hybridization in situ. The staining results were observed under microscope. It was found that moesin mRNA expression was increased in the tissues of liver, kidndy and spleen in mice treated with LPS, while in the mice pre-treated with F(022) part from Radix Isatidis, the LPS-induced moesin mRNA expressions in these tissues were inhibited in a dose-dependant manner. Our study showed that F(022) part from Radix Isatidis can inhibit the LPS-induced expression of moesin mRNA in the tissues of liver, kidney and spleen in mice.

Objective To investigate the characteristics and mechanism of spironolactone ent-kaurane diterpene type diterpene rabdosin B (RB) induced HL-60 differentiation into mature granulocytes. Methods The effects of RB on proliferation, cell cycle, NBT reducing power, phagocytosis, and cell surface antigen CD11b expression of HL-60 were detected by trypan blue staining, Giemsa staining, NBT reducing power assay, and flow cytometry, respectively. Results RB inhibited the proliferation of HL-60 cells at the concentration of 1.0, 3.0, and 5.0 μmol/L, which resulted in the arrest of G0/G1 phase, increased the ratio of renal nucleated and lobate nucleus, and markedly enhanced the NBT reducing power and phagocytic capacity and the significant increase of CD11b positive cell rate. Further tests showed that the active oxygen scavenger NAC (300 μmol/L), NADPH oxidase inhibitor APO (100 μmol/L), and DPI (0.1 μmol/L) not only significantly inhibited the intracellular ROS upregulation induced by RB, but also inhibited various features of RB induced HL-60 cell differentiation. Conclusion RB can increase the activity of NADPH oxidase in HL-60 cells, increase the intracellular ROS concentration, and induce the differentiation of HL-60 cells to mature granulocytes.

Objective To develop a rapid ultra high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/ MS) for determination of 11 sedative-hypnotics in human plasma. Methods The plasma samples were extracted with dichloromethane:n-hexane:acetoacetate (5∶4∶1). The separation was performed on a Waters ACQUITY UPLC HSS T3 column (2.1 mm×100 mm,1.8 μm) using the mobile phase composed of acetonitrile-0.1% ammonium solution at a flow rate of 0.2 mL?min-1 in gradient elution mode. The detection was performed on a triple quadrupole tandem mass spectrometer by multiple reaction monitoring (MRM) via electrospray ionization (ESI) source in positive mode. Results Good linear relation was obtained over the investigated concentration range, with all correlation coefficients higher than 0.99. The limit of detection was 200 pg?mL-1 for dexzopiclone,and 10- 20 pg?mL-1 for other sedative-hypnotics. The intra- and inter-day RSD of 11 sedative-hypnotics were no more than 15.0%. The recoveries were in the range of 72.3%-108.0%, and the matrix effects were approximately 0.86- 1. 12. Conclusion The method is rapid, sensitive and reliable, and suitable for the simultaneous determination of 11 sedative-hypnotics in human plasma.

The immunoregulation effect to polysaccharides from Bifidobacterium spp. was investigated on the base of functional assessment standards of health food. Effects of the EPS on immunity were investigated by promoted the proliferation of spleen lymph cells, delayed type hypersensitivity reaction, the HC50 value and macrophage function assay in mice. Data showed that the EPS could obviously increase the ratio of swallowed chicken red blood cell by macrophage and the HC50 value in mice. However, no significant effect was found on the delayed type hypersensitive induced by sheep red blood cell, for only the low dose of 100 mg/(kg?d) EPS promoted the proliferation of spleen lymph cells. Bifidobacterium spp. EPS can certain immunomodulating function.