Objective To introduce the development of facial recess of 210 cases who recieved cochlear implantation and experienced the opening of the facial recess under the direction of high resolation computed tomography(HRCT).Methods The facial recess was assessed and measured using the HRCT before cochlear implantation in 210 patients who suffered from severe and profound sensorineural hearing loss.A statistic analysis was performed according to the age group,and the findings during the operation were compared with that before the surgery.Results The facial recess of 13 cases (6%) did not developed.The mean volume of the rest facial recess was 4.26 mm3 in 197 cases,while in 12.0 years group(group C) it was 3.09 mm3.The differences among three groups were statistically significant. The findings during the operation was agreed with the assessment results prior to the surgery.Conclusion 94% facial recesses developed in all 210 cases.Employment of HRCT scan prior to the surgery allows auurate determination of the location of facial recess to ensure successful surgery.

OBJECTIVE To investigate the choise of operation approach for chronic otitis media surgery. METHODS Auditory and high resolution computed tomography (HRCT) assessment were carried out prior to the operation in 160 ears with otitis media. Tympanoplasty or mastoidectomy and tympanoplasty were performed. RESULTS Thirty-one patients received tympanoplasty and 129 patients received mastoidectomy and tympanoplasty. Closed and opened surgery were performed in 49 and 80 cases respectively. The ear-drying time ranged from 7 to 51days with an average of 23 days. Mean hearing increased by 15dB. CONCLUSION Assessing the HRCT scan prior to the surgery can help us choose a reasonable approach in chronic otitis media surgery.

AIM To investigate the activation of p38 protein kinase in alveolar macrophages(AMs) stimulated with lipopolysaccharide(LPS) and the effects of dexamethasone(DEX) and N acetylcysteine(NAC) on the process. METHODS AMs isolated and purified from normal rats were divided into four groups:Control group, LPS stimulated group ,DEX group and NAC group. The activation of p38 protein kinase in nuclear protein extract from the AMs and the concentration of TNF ? and IL 8 in supernatant were measured by Western blot and radioimmunoassay, respectively. RESULTS The activation of p38 protein kinase and the concentration of TNF ?, and IL 8 in LPS stimulated group were significantly higher than those in control group( P

Objective Few prospective data are currently available on acute gastrointestinal hemorrhage (AGIH) as a complication in acute kidney injury (AKI).The aim of the present study was to find out clinical characteristics,incidence,etiology,risk factors,and outcome of AGIH in patients with AKI.Methods We performed a prospective study on an inceptione cohprt of 512 patients admitted for AKI in our hospital.Data on clinical risk factors for bleeding,frequency of occurrence of AGIH,in-hospital mortality were collected,and independent predictors of AGIH were identified.Results A total of 53 patients had AGIH as a complication of AKI,and 45 were upper AGIH.Fifteen patients had clinically severe bleeding.Independent baseline predictors of AGIH were severity of illness,cardiac failure,mechanical ventilation,low platelet count,chronic hepatic disease,liever cirrhosis,severe AKI.Inhospital mortality was 52.8％ in patients with AGIH,and 22.2％ in the other patients.AGIH was significantly associated with an increase in hospital mortality.Conclusions AGIH are frequent complications of AKI.In this clinical condition,AGIH is more often due to upper gastrointestinal bleeding and is associated with a significantly increased risk of death.Both renal and extrarenal risk factors are related to the occurrence of AGIH.

Objective To explore the effects of VEGF/bFGF sustained release microspheres combined with hyperbaric oxygen therapy on survival rates of uhralong random pattern flaps in rats.Methods Modified McFarlane flap rat models were randomly divided into 4 groups,VEGF/bFGF microspheres + hyperbaric oxygen group,VEGF/bFGF microspheres group,hyperbaric oxygen group and control group.At the end of 7 days,survival rates of flaps were calculated (Survival rate =Survival area/total area × 100％).The tissue samples were taken from middle portion of flaps to detect the neovascularization.Immunohistochemistry was used to detect the differential expression of VEGF.Results Seven days after the random pattern flap operation in rats,the survival rates of VEGF/bFGF microspheres combined with hyperbaric oxygen therapy experimental group,VEGF/bFGF microspheres experimental group,hyperbaric oxygen therapy experimental group,and control group were (89.54 ± 3.23) ％,(73.54 ± 4.57) ％,(71.89 ± 2.26) ％,(50.36 ± 2.37) ％ respectively.The neovascularization counts of each group in part Ⅱ were (35.14 ± 4.21)/mm2,(23.34 ± 2.53)/mm2,(25.22 ±2.73)/mm2 and (17.37 ± 5.73)/mm2 respectively.VEGF cumulative absorbance in VEGF/bFGF microspheres + hyperbaric oxygen group,VEGF/bFGF microspheres group,hyperbaric oxygen group and control group were 78.39 ± 9.12,52.42 ± 13.59,49.84 ± 12.93,29.24 ± 10.35 respectively.In each experimental result group,there were significant difference between the combination group and the other groups (F =189.956,P ＜ 0.05),but there was no significant difference between VEGF/bFGF microspheres experimental group and hyperbaric oxygen therapy experimental group.Conclusion VEGF/bFGF sustained release microspheres combined with hyperbaric oxygen therapy can promote flap neovascularization,increase the flap blood supply and then improve the survival of random pattern skin flaps.

OBJECTIVE: To summarize the operation approach and management during cochlear implant operation in children with sigmoid sinus antedisplacement. METHOD: Five hundred and thirty-eight profound hearing loss children were performed auditory and imagiological examinations before cochlear implant. We analyzed the location of the sigmoid sinus from the high resolution CT scan and then performed cochlear implant to all these patients. RESULT: In all these 538 cochlear implant children, 4 cases (0.74%) had significant sigmoid sinus antedisplacement which cause the operation more difficult, 64 cases (11.9%) had slight sigmoid sinus antedisplacement which did not impact the ordinary cochlear implant procedures. CONCLUSION Significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures were seldom happen in children. In 538 cochlear implant children of our center, 4 cases had significant sigmoid sinus antedisplacement that impact cochlear implant operative procedures, we successfully complete these 4 operation through removal of the incus and abrasive reduction the posterior wall of bony external acoustic meatus.
Child ; Child, Preschool ; Cochlear Implantation ; methods ; Female ; Hearing Loss ; diagnostic imaging ; therapy ; Humans ; Infant ; Male ; Paranasal Sinuses ; abnormalities ; diagnostic imaging ; Tomography, X-Ray Computed

Objective To observe the effect of intermedin(IMD) on microvascular injury of renal fibrosis in unilateral ureteral obstruction (UUO) rat model.Methods Seventy-two male Wistar rats were randomly divided into two groups:the sham-operation group (n=24) underwent the left ureteral dissection,the other 48 rats were made as unilateral ureteral obstruction models and subdivided into model group(UUO,n=24) and IMD group (n=24).At the 7,14,21,28 day after the operation,6 randomly-selected rats from each of the three groups respectively were blooded by abdominal arotic and their obstructive kidneys were taken out.The renal histopathological changes were observed through HE and Masson staining,the contents of BUN,Scr and cystatin C (CysC) of the obstructive kidneys were determined,the expressions of transforming growth factor-β1 (TGF-β1),α-SMA,bone morphogenetic protein-7 (BMP-7),E-cadherin,thrombospondin 1 (TSP-1) and vascular endothelial growth factor (VEGF) were detected by RT-PCR and immunohistochemistry.Results Compared with the sham-operated group,the pathological changes of kidney in the model group showed that the degree of fibrosis was obvious,tubular interstitial damage aggravated,the levels of BUN,Scr,CysC in the model group increased (P ＜ 0.05),the mRNA expression and protein content of TGF-β1,oα-SMA,TSP-1 increased (P ＜ 0.05),while the levels of BMP-7,E-cadherin and VEGF decreased (P ＜0.05).Compared with the UUO group,renal tubular damage,interstitial fibrosis in the IMD group were lighter,the levels of BUN,Scr,CysC in the IMD group were lower (P ＜ 0.05),the mRNA expression and protein content of TGF-β1,α-SMA,TSP-1 were down-regulated (P ＜ 0.05),while the levels of BMP-7,E-cadherin and VEGF were up-regulated (P ＜ 0.05).Conclusion IMD can ameliorate the renal interstitial fibrosis,and the mechanism may be related to the fact that VEGF mediated by IMD can reduce vascular injury.

Objective To investigate the differences in the safety of the operation of different hepatic vascular exclusion for liver surgery. Methods Sixty patients with liver resection were grouped by different hepatic blood flow blocking methods, and given pre-operative assessment prior to surgery. Results On the first day after surgery, the average levels of ALT and AST were (395.0 ± 220.2) U/L and (415.3±311.0) U/L in patients who received Pringle’s method (110.2±53.0) U/L and (125.6±78.5) U/L in patients who received regional hepatic vascular exclusion, (98.9±32.2) U/L and (96.2 ±66.5) U/L in patients who didn't receive hepatic vascular exclusion, respectively. Postoperative liver function damage was more serious in patients who received Pringle's method than patients who received regional hepatic vascular exclusion or patients who didn't receive hepatic vascular exclusion, the difference was statistically significant (P<0.05) .Conclusion Regional hepatic vascular exclusion or not can not only reduce the incidence of postoperative complications, but also expand the indications for liver resection.

Objective To investigate the protective effects of lentivirus mediated Bcl-2-associated athanogene 1L (BAG-1L) over-expression on human neuroblastoma cells (SH-SYSY) induced by hypoxia/re-oxygenation,and to study its effect on the phosphoinositide 3 kinase serine/threonine protein kinase (PI3K/AKT) pathway.Methods SH-SYSY cells were cultured in vitro,and the cells at logarithmic phase were collected,and they were divided into recombined lentiviral infection group [infected by lentivirus containing BAG-1L and green fluorescent protein (GFP) gene],vector control group (infected by lentivirus containing GFP without BAG-1L gene) and cell control group (non-infection).Western Blot was used to detect the expression of BAG-1L in target cells after infection for 48 hours.SH-SY5Y cells were subjected to hypoxia for 8 hours and re-oxygenation for 24 hours,then the cell counting kit-8(CCK-8) was used to detect the cell activity,and the apoptosis was detected by flow cytometry after allophycocyanin labeled annexin V/7-amino actinomycin D (Annexin V-APC/7-AAD) staining.Western Blot was used to detect the protein expressions of BAG-1L,heat shock protein 70 (HSP70),AKT and phosphorylated AKT (p-AKT).Results After infection for 48 hours,exogenous BAG-1L protein bands were observed in recombined lentiviral infection group,but not observed in cell control group and vector control group.After hypoxia/re-oxygenation treatment,the cell viability in recombined lentiviral infection group was significantly higher than that in cell control group and vector control group (A value:0.689 ± 0.036 vs.0.425 ± 0.013,0.400 ± 0.012),apoptosis was significantly decreased [apoptosis rate:(26.97 ± 1.82)％ vs.(36.60± 1.45)％,(35.77 ± 3.74)％],the protein levels of BAG-1L,HSP70 and p-AKT were significantly increased [BAG-1L protein (gray value):2.405 ± 0.167 vs.0.529 ± 0.141,0.601 ± 0.099;HSP70protein (gray value):0.997±0.123 vs.0.634±0.091,0.584±0.106;p-AKT protein (gray value):1.234±0.118 vs.0.661 ± 0.210,0.712 ± 0.199,all P ＜ 0.01],but the protein level of AKT was slightly increased (gray value:1.103 ± 0.269vs.0.646 ± 0.188,0.791 ± 0.326) without statistically significant differences (both P ＞ 0.05).There was no significant difference in all parameters between cell control group and vector control group (all P ＞ 0.05).Conclusion Lentivirus mediated BAG-1L gene over-expression can protect nerve cells against hypoxic injury and apoptosis,and the protective effect may be related to the activation increase of pathway on PI3K/AKT.

Objective Comparing the dosimetric characteristics of volumetric modulated arc therapy (VMAT) and constant dose rate intensity modulated arc therapy (IMAT) in esophagus cancer to evaluate the performance of the two different arc therapy delivery techniques.Methods 22 cases of esophageal cancer patients were selected for the planning comparison study.All plans were done for IMAT and VMAT treatment plans on Oncentra 4.1 treatment planning system,prescription dose of 2 Gy in total 30 fractions.Planning objectives for PTV were at least 95％ reached the prescription dose and V110 no more than 10％.The maximum dose of spinalcord below 45 Gy and double lung dose V20 ≤ 28％,V30 ≤ 18％ were constrained.Plans were evaluated based on the ability to meet the dose volume histogram.The dose homogeneity index (HI),radiation conformity index (CI),radiation delivery time,monitor units and γ pass rate were also compared.SPSS 19.0 software paired ttest analysis was carried out on the two sets of data.Results The results showed that the IMAT plans in terms of the PTV's CI (t =3.35,P=0.003),D2(t =-2.27,P=0.034) lung's V30(t =-2.46,P=0.023) were better than that of VMAT group.But the VMAT plans spinal's V40 (t =2.37,P =0.027),lung's V5 (t =2.43,P =0.024) were superior to that of IMAT plans.There were no significant differences between IMAT and VMAT plans in the average dose of PTV,CTV,GTV,heart,spinal cord,double lung and the γpass rate.Conclusion IMAT presents a slight improvement in the OAR sparing in high dose with shorter treatment time when compared to VMAT.While in terms of delivered MU and tissue of low dose irradiated area is higher than that of in VMAT.These two treatment methods all can meet the clinical demand,which should be selected according to the actual situation of the patient.